Signs Of Early Onset Parkinson’s Disease
09 July, 2018
Early onset Parkinsons disease begins before the age of 50. Its a neurodegenerative disorder that affects the nervous system. It causes damage and the subsequent degeneration of the neurons located in the substantia nigra. The average age of Parkinsons onset is 60 and the incidence increases significantly with age. However, about 5 to 10 percent of those with Parkinsons disease have early onset Parkinsons beginning before the age of 50.
Mutations of specific genes such as the parkin gene may contribute to its onset. People with one or more close relatives with Parkinsons are at a higher risk of developing the disease.
Overall, the chances of developing the disease are only 2 to 5 percent unless theres a family history of the disease. Its estimated that between 15 and 25 percent of people with Parkinsons know they have a relative with the disease.
In very rare cases, the symptoms of Parkinsons may appear in people younger than 20. This is known as juvenile parkinsonism. It usually begins with the symptoms of dystonia and bradykinesia. The drug levodopa can often improve these symptoms.
Circumstances And Societal Engagement In Yopd And Implications For Management
In general, people with YOPD tend to have different family and societal engagements to those with late-onset PD. For example, most people diagnosed with YOPD will have a job, whereas some people with late-onset PD have already retired. Additionaly, it is not unusual that people with YOPD have young children , or may want to start a family.
Overview Of Parkinson’s Disease
Parkinson’s disease is a chronic progressive neurological disease that affects a small area of nerve cells in an area of the brain known as the substantia nigra. These cells normally produce dopamine, a chemical that transmits signals between areas in the brain that, when working normally, coordinate smooth and balanced muscle movement. Parkinson’s disease causes these nerve cells to die, and as a result, body movements are affected.
“Parkinsonism” is a term that is often used interchangeably with Parkinson’s disease. Medically, parkinsonism refers to any condition that causes symptoms similar to Parkinson’s disease tremors at rest, muscle rigidity, slow movement, and changes in walking. Parkinson’s disease is probably the most common form of parkinsonism. Other conditions that cause it include:
- Medications such as reserpine, Thorazine
- Toxic exposures to carbon monoxide, cyanide
- A variety of other neurologic conditions affecting the nerves in the substantia nigra such as Wilson’s disease and progressive supranuclear palsy
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What Is The Trend Over Time In The Prevalence And Incidence Of Parkinsonism In Canada
Between 20042005 and 20132014, the number of Canadians living with diagnosed parkinsonism increased from approximately 61,000 to 84,000, while the number of Canadians newly diagnosed increased from approximately 8,000 to 10,000. However, during the same period, there was no significant change in the age-standardized prevalence proportion, which remained at 0.4%, or the incidence rate, which went from 51.6 per 100,000 to 52.6 per 100,000. The sex differential also remained constant over time for both indicators .
Figure 3: Age-standardized prevalence and incidence of diagnosed parkinsonism, including Parkinsons disease, among Canadians aged 40 years and older, by sex, 20042005 to 20132014
Notes: Age-standardized estimates to the 2011 Canadian population. The 95% confidence interval shows an estimated range of values which is likely to include the true value 19 times out of 20. The 95% confidence intervals of the prevalence estimates are too small to be illustrated.Data source: Public Health Agency of Canada, using Canadian Chronic Disease Surveillance System data files contributed by provinces and territories, July 2017.
Make An Appointment With A Physical Therapist Or Occupational Therapist
- One of the most common phrases we hear from people with Parkinsons is, I wish I had seen a physical therapist sooner. Doing your daily exercise program isnt enough. Physical therapists and occupational therapists create individualized exercises that meet your specific needs. The activities they recommend can improve your posture, gait, arm swing, and other movement challenges.
- to find a Parkinsons PT in your area.
- to learn why youll want to work with a Parkinsons OT.
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Young Onset Parkinsons : An Introduction
Although the average age to develop Parkinsons is around 60, young onset Parkinsons occurs in 5-10% of people diagnosed. 20% are under the age of 50. Some challenges in Parkinsons are universal, regardless of age, but there are a number of issues specific to younger people.
Generally, Parkinsons proceeds more slowly in younger people. While no two people are the same, someone whose onset age is 40 can expect to work for another 15-20 years on average. For someone with an onset age of 60, the average figure would be half that. These figures are based on the kinds of treatment available today. Future treatment will be even more effective in prolonging the productive life of people with Parkinsons.
Larry Gifford hosts a panel discussion on Living Well with Young Onset Parkinsons in May of 2020.
The following characteristics tend to be present in young onset Parkinsons:
- Young onset Parkinsons is less likely to lead to dementia and balance problems
- It is more likely to include focal dystonia, which is cramping or abnormal posturing of one part of the body.
- Younger people are more sensitive to the benefits of Parkinson medications, but they tend to experience the dyskinetic side effects of levodopa sooner than older people.
- They also tend to experience dose-related fluctuations at an earlier stage of the disease, including wearing off* and the on-off effect. See Parkinson Canada Information Sheet, Parkinsons Medications: What you need to know!
Parkinsons Disease Risk Factors
You could be at greater risk for Parkinsons development if you
- Are a men
- Live in an environment that has such organic or synthetic toxins.
- Have a career exposing you to poisonous substances like manganese or lead.
- Expose yourself to chemical solvents or polychlorinated biphenyls.
- Have been injured in the traumatic brain.
- Have been exposed to Agent Orange or other herbicides.
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Young Onset Parkinson’s: A Conversation Of Our Unique Needs
In this one-hour video, a panel of people with Young Onset Parkinson’s Disease discuss the challenges faced by those with YOPD. The panel features Larry Gifford, famous for his podcast “When Life Gives You Parkinson’s,” Dr. Soania Mathur, a member of Parkinson Canada’s Medical Advosory Council, Tim Hague, who won the first Amazing Race in Canada after being diagnosed, and Omotola Thomas, founder of ParkinStand.
What Are The Management Options For Canadians Living With Parkinsonism
There is currently no cure for Parkinsons disease and most other parkinsonism cases. However, treatment options are available to help mitigate the symptoms and health impacts associated with these conditions. Most often the primary treatment is pharmacological, but it may also include other therapeutic options and, in the case of Parkinsons disease, surgical interventions. Studies have shown that specially tailored exercise programs, supervised by physiotherapists or other trained professionals, may help affected individuals maintain or improve their physical functionality and general well-being.Footnote 2 Footnote 3 Footnote 4 Footnote 5
Box 1: What’s in the data?
The data used in this publication are from the Canadian Chronic Disease Surveillance System , a collaborative network of provincial and territorial chronic disease surveillance systems, led by the Public Health Agency of Canada . The CCDSS identifies chronic disease cases from provincial and territorial administrative health databases, including physician billing claims and hospital discharge abstract records, linked to provincial and territorial health insurance registry records using a unique personal identifier. Data on all residents eligible for provincial or territorial health insurance are captured in the health insurance registries.
Definition of diagnosed parkinsonism, including Parkinsons disease, in the CCDSS
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Treatment Of Young Onset Parkinsons Disease
Young onset patients face unique circumstances regarding medical and surgical treatments of Parkinsons disease. In general, the same medications used to treat late onset Parkinsons patients are used for treatment of young onset patients. However, younger patients are at increased risk for certain side effects compared to elderly patients, most notably excess involuntary movements often of the limbs called dyskinesias with use of levodopa. Therefore, a personalized and individualized approach using other medications instead of, or in conjunction with levodopa is often used to mitigate side effects.
Who Gets Early Onset Parkinsons Disease
About 10%-20% of those diagnosed with Parkinsons disease are under age 50, and about half of those are diagnosed before age 40. Approximately 60,000 new cases of Parkinsons are diagnosed each year in the United States, meaning somewhere around 6,000 12,000 are young onset patients.
Is it genetic or hereditary?
The cause of Parkinsons disease is not yet known. However, Parkinsons disease has appeared across several generations of some families, which could indicate that certain forms of the disease are hereditary or genetic. Many researchers think that Parkinsons disease may be caused by genetic factors combined with other external factors. The field of genetics is playing an ever greater role in Parkinsons disease research, and scientists are continually working towards determining the cause or causes of PD.
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Im 35 With Two Young Children And Parkinsons
At 29, Ellie was diagnosed with Parkinson’s disease. Despite how people sometimes react, and having to accept compromises in caring for her children, she decided it wasn’t going to stop her living her life the way she wanted to. This 5-minute read includes Ellie’s story and a link to her blog about life as a young mom with Parkinson’s disease, PD Mom.
Consider Deep Brain Stimulation Surgery
- Talk with your doctor about whether you would be a good candidate for Deep Brain Stimulation. DBS is an FDA-approved surgical technique that involves a surgeon implanting a neurostimulator that delivers electrical current to certain parts of the brain. When these targeted areas of the brain are stimulated, it blocks the abnormal nerve signals that cause tremor and other Parkinsons symptoms. One person with YOPD described his DBS surgery as a buyback of life and daylight savings time on steroids because he noticed such a difference in his quality of life.
- Watch this panel of DBS experts weigh in on the benefits of DBS.
Diagnosis Of Parkinsons Disease
A number of disorders can cause symptoms similar to those of Parkinson’s disease. People with Parkinson’s-like symptoms that result from other causes are sometimes said to have parkinsonism. While these disorders initially may be misdiagnosed as Parkinson’s, certain medical tests, as well as response to drug treatment, may help to distinguish them from Parkinson’s. Since many other diseases have similar features but require different treatments, it is important to make an exact diagnosis as soon as possible.
There are currently no blood or laboratory tests to diagnose nongenetic cases of Parkinson’s disease. Diagnosis is based on a person’s medical history and a neurological examination. Improvement after initiating medication is another important hallmark of Parkinson’s disease.
Tell Us About When You Were Diagnosed With Parkinsons:
So let me start at the very beginning of the story. My mom had early onset Parkinsons. She was diagnosed very young, when she was 23. This meant that when I was growing up, Parkinsons was always a part of our lives. And it was always in the back of my mind is there a genetic component to this? Am I also going to get Parkinsons?
When I was 31 and my wife and I were dating, she noticed that my left side was moving slower than my right and that I had a quiver in my lip. She asked me to get checked out. As a nurse, of course, I put it off for as long as possible.
I put off dealing with it for about a year and then right before we got married, about two months before our wedding, I got the diagnosis.
In the back of my mind, I think I knew all along what was going on. But avoidance and denial will take you a long way!
Before our wedding, we talked about Parkinsons disease a lot. My wife and I have excellent communication that is the foundation of our relationship. We had deep and heavy conversations about the reality of situation and about the hopes, dreams and expectations that may not happen for us.
We decided, obviously, to stay together and pursue this journey as a team.
We did not tell anyone for about a year. After a year, we told our close family. And then it was about another one to two years until I publicly disclosed. That I did very recently.
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Michael J Fox On How Accepting Parkinsons Diagnosis Changed His Perspective
I wasnt quite ready for that yet, she said. I immediately changed my diet. I immediately started exercising.
Exercise can help people with Parkinsons disease, James Beck, chief scientific officer of the Parkinsons Foundation, said.
Its not a cure-all, but it does wonders to help to manage symptoms, keeps people moving, which is really important, helps maintain muscle strength, he told TODAY. Its a rising tide that raises all boats helping people to live a better life.
Day did eventually start taking medication and her symptoms waned. But it was tough being so young and having a condition often associated with older people.
I didnt know anybody young and that was really hard, she said. I dreamed of having one friend or somebody that had my situation.
After a year of searching, she found someone with young onset Parkinsons disease. Then she met another and she decided to start a Facebook group of people in the area with the condition.
Its grown organically at this point. Theres 40 something people and weve gotten together of times in person, Day said. The optimism and hope that I bring to situations is not as common as I thought and I have an opportunity to help people and I enjoy that.”
What Causes Parkinson’s Disease
Parkinsons disease occurs when nerve cells in the basal ganglia, an area of the brain that controls movement, become impaired and/or die. Normally, these nerve cells, or neurons, produce an important brain chemical known as dopamine. When the neurons die or become impaired, they produce less dopamine, which causes the movement problems of Parkinson’s. Scientists still do not know what causes cells that produce dopamine to die.
People with Parkinson’s also lose the nerve endings that produce norepinephrine, the main chemical messenger of the sympathetic nervous system, which controls many functions of the body, such as heart rate and blood pressure. The loss of norepinephrine might help explain some of the non-movement features of Parkinson’s, such as fatigue, irregular blood pressure, decreased movement of food through the digestive tract, and sudden drop in blood pressure when a person stands up from a sitting or lying-down position.
Many brain cells of people with Parkinson’s contain Lewy bodies, unusual clumps of the protein alpha-synuclein. Scientists are trying to better understand the normal and abnormal functions of alpha-synuclein and its relationship to genetic mutations that impact Parkinsons disease and Lewy body dementia.
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Symptoms Of Early Onset Parkinsons Disease
While common symptoms of PD maybe similar no matter what age you are, the progression is often different.There are four primary motor symptoms of PD, including: tremor,rigidity, bradykinesia , and postural instability .
Young people often have more involuntary movementproblems due to side effects from the most commonly prescribed PD medication,levodopa. Other problems associated with PD such as memory loss, confusion, andbalance difficulties tend to be less frequent in young people with the disease.
I Was Hit By Parkinson’s At Eighteen
Michael Gibson was just 18 when he became one of the youngest people ever to be diagnosed with Parkinson’s Disease, a degenerative brain disorder that normally affects older people.
Now 25, Michael, a television presenter and film director who lives in London, tells LESLEY GIBSON his moving and inspiring story…
The doorman eyed me suspiciously and refused to let me enter the nightclub. ‘You’ve been taking drugs,’ he said. ‘Look at you. You’re shaking.’ It wasn’t illegal substances making my hands tremble, it was Parkinson’s disease. But the doorman didn’t believe me when I told him. ‘Young lads don’t get that,’ he sniggered.
‘It’s an old person’s disease.’ I was 18, and trying to be a normal teenager on a night out. I felt so upset, angry and frustrated that I gave up arguing and went home. That was my first unpleasant taste of the ignorance and prejudice I would face over the next few years. Although I felt angry about the doorman’s attitude, I wasn’t surprised other people couldn’t accept I had Parkinson’s, because, deep down, I couldn’t accept it myself. I will never forget the day I was diagnosed.
I’d spent half an hour doing tests that seemed pointless: drawing circles on a piece of paper, making pincer movements with my hands, walking up and down the room.
I didn’t tell my tutors about the condition. I didn’t want pity or special treatment. I felt really angry about it and I’d release my aggression on nights out, by getting into fights.
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Diagnosis In Young Onset Parkinsons
Many young onset patients experience delay in diagnosis given the uncommon age and often different symptoms as outlined below. Similar to late onset patients, the diagnosis is made based on history and clinical examination. There are still no proven diagnostic tests that can definitively diagnose PD. In some cases, other mimics of Parkinsons need to be evaluated for given their increased likelihood in younger patients. Given the complexities, it is important to seek evaluation by a neurologist and in many cases a movement disorder specialist.
In addition, young onset patients are more likely to have a genetic risk factor or cause to their symptoms, especially if there is a family history. Genetic testing can be considered, but should always be done after consulting a physician and in many cases a genetic counselor.