Early-onset Parkinson's disease

Many people with early-onset Parkinson's will not experience some of the symptoms associated with the disease for many years. (Photo: Pixabay.com)

According to the American Parkinson Disease Association, early-onset Parkinson's occurs when a doctor diagnoses the disease in a person 21 to 50 years old.

While a Parkinson's diagnosis can be devastating at any time of life, being diagnosed with the disease at an early age can significantly impact a young person's quality of life and that of their family. Currently, there is no cure for the disease.
Because doctors most often diagnose Parkinson's disease in people around 60 years old, it is likely that a much younger person with early-onset Parkinson's disease could remain undiagnosed or misdiagnosed for some time.

Early-onset Parkinson's may also progress differently to the more traditional form of the disease. Being aware of symptoms and risk factors may help a person get the treatments they need as early as possible.

Early-onset Parkinson's definition

According to the American Parkinson Disease Association, an estimated 10 to 20 percent of those with Parkinson's disease are diagnosed at an early age. This amounts to anywhere from 6,000 to 12,000 people under 50 years old in the United States.
Many people with early-onset Parkinson's will not experience some of the symptoms associated with the disease for many years. People diagnosed with Parkinson's at an older age tend to progress to these symptoms more quickly.

These symptoms include:
•    confusion
•    memory loss
•    problems with balance

However, people with early-onset Parkinson's are more likely to experience problems with involuntary movements — jerking or other tics that a person has no control over. These movements may be due to the disease itself or a result of the side effects of a medicine called levodopa, which is commonly prescribed to treat the disease.

For this reason, some doctors will prescribe different medications to treat early-onset Parkinson's. In addition to differences in symptoms and treatments, those diagnosed with early-onset Parkinson's disease also face different challenges in living with the disease. For example, they may be parents of young children or just starting out in their careers without insurance or savings for medical costs.

Signs and symptoms

According to an article in the journal Translational Neurodegeneration, changes in the brain begin to occur an estimated 6 years before a person experiences symptoms of Parkinson's. Parkinson's disease causes a reduction of dopamine in the brain, which may be responsible for movement-related symptoms. These symptoms are similar in people diagnosed with both early-onset Parkinson's disease and those diagnosed at a later age.

Examples of movement-related symptoms include:
•    tremors, or small, shaking movements of the hands, arms, legs, jaw, or face
•    stiffness or rigidity of the arms, legs, or trunk
•    slow, stiff movements
•    affected balance
•    affected coordination

Parkinson's disease can also cause other symptoms besides impaired movement. These include:

•    changes to thinking or memory
•    depression
•    problems going to the bathroom, such as constipation or urinary incontinence
•    sleeping problems

Diagnosis

Currently, no specific test exists to help a doctor diagnose Parkinson's disease. Diagnosis often involves ruling out other medical conditions that can cause similar effects. Doctors may also compare a person's symptoms with those of a younger person already diagnosed with Parkinson's disease.

Sometimes, a doctor may ask a person to keep a diary of their symptoms. Tracking these symptoms over time may help a doctor to identify a Parkinson's-like pattern of symptoms.

Examples of diagnostic testing to rule out other conditions include:
•    imaging scans of the brain to test for brain abnormalities, such as tumors
•    blood testing to identify the presence of bacterial or viral illnesses, or cancers

Sometimes, a doctor might prescribe medications that are typically used to treat Parkinson's disease to see if a person's symptoms improve. If a person's symptoms do improve, this might suggest that a person has Parkinson's disease.

Text: Rachel Nall, RN, BSN, CCRN – 01/2018
Article slightly abridged
With kind permission to publish from MNT