Early onset Parkinson’s disease (also known as young onset Parkinson’s disease) is a form of Parkinson’s disease (PD) that begins before the age of 50 years. The movement disorder, which is most often diagnosed in people over the age of 60, affects approximately 60,000 new people in the United States each year. Roughly 10 percent to 20 percent of these people are diagnosed with early onset PD. However, this estimate may be low — early onset PD may be misdiagnosed or go undiagnosed in some younger people.

Symptoms of Early Onset Parkinson’s Disease

Symptoms of early onset PD are similar to symptoms of PD that begins later in life.

Some of the classic motor symptoms include:

• Tremors and other involuntary movements
• Rigidity
• Bradykinesia (slowness of movement)
• Impaired balance and coordination

Other symptoms include:

• Depression, anxiety, and other emotional disturbances
• Sleep problems
• Difficulties in memory and thinking
• Urinary problems or constipation

Compared to people who develop Parkinson’s at an older age, people with early onset PD may have more motor symptoms and fewer nonmotor symptoms.

Causes and Risk Factors for Early Onset Parkinson’s Disease

PD is caused by a lack of dopamine in the brain. Dopamine is a neurotransmitter (brain chemical) that’s involved in movement and cognitive functioning (memory, learning, and thinking). It’s not well understood why cells that create dopamine die off in people with PD.

Some research suggests that certain genes and genetic mutations may be associated with an earlier onset of parkinsonism symptoms. These genes include:

• PARK2
• PINK1
• PARK7
• LRRK2

One study found that 18 percent to 50 percent of cases of early onset Parkinson’s had PARK2 mutations. Having these genes alone may not mean a person will develop early onset PD, however.

Like in PD, environmental factors may also play a role in the development of early onset disease. It’s likely that an interaction between these factors and genetic risk factors contribute to disease onset. One study found that drinking well water and experiencing a head injury were risk factors for the development of young onset Parkinson’s. This same study also found that exercise was a protective factor. That said, the causes and risk factors for PD are not well understood at this time, and research is ongoing.

Diagnosing Early Onset Parkinson’s Disease

To diagnose PD at any age, a doctor will typically need to perform a physical examination and a neurological examination using brain imaging scans such as MRI and positron emission tomography (PET).

While an MRI scan looks for structural abnormalities in the brain, a PET scan looks at brain metabolism. In cases of suspected PD, a neurologist will look for the metabolism of dopamine, as the destruction of dopamine cells in the brain is a hallmark of Parkinson’s.

Treatment Options for Early Onset Parkinson’s Disease

There currently is no way to prevent or cure PD. However, several anti-parkinsonian drugs are available to help people cope with their symptoms. These medications temporarily reduce PD symptoms by enhancing dopamine levels, mimicking dopamine, or inhibiting the breakdown of dopamine. Some of these drugs include:

• Levodopa (carbidopa), a dopamine promoter that has been classically used to slow progression of PD
• Gocovri (amantadine), an antiviral and dopamine agonist (drug that increases the action of dopamine)
• Other dopamine agonists

However, these drugs are not without their own complications. For instance, Levodopa may cause more motor side effects in younger people than in older people. As a result, doctors may hold off on using this medication to treat people with early onset PD due to these Levodopa-induced dyskinesias. Instead, health care providers may opt for other medications or deep brain stimulation, a surgical option to help control motor symptoms.

Prognosis and Outlook for Early Onset Parkinson’s Disease

Compared to Parkinson’s in older people, disease progression in younger people may be slower. Younger people may also have a longer disease duration. As a result, they may suffer from more significant physical, economic, and psychological consequences. One study found that a younger age at PD onset was associated with poorer quality of life scores and poor emotional well‐being, making early diagnosis and treatment especially important.

Building a Community

MyParkinsonsTeam is the social network for people with Parkinson’s disease and their loved ones. On MyParkinsonsTeam, members come together to ask questions, give advice, and share their stories with others who understand life with Parkinson’s disease.

Do you or a loved one have early onset Parkinson’s disease? Share your experience in the comments below, or start a conversation by posting on MyParkinsonsTeam.