Parkinson’s can occur at any age. Early onset Parkinson's, also known as young onset Parkinson’s (YOPD), is defined as occurring in someone below the age of 40. Research suggests that genetics may play more of a role in early or young onset than in people who are diagnosed over the age of 40.
In early or young onset Parkinson's, the symptoms you experience and how you respond to medication may differ slightly from older onset, although for some people these can be very similar.
Motor (movement) symptoms generally respond well to medication in both young and older onset Parkinson’s. In early or young onset, motor fluctuations such as dyskinesia (abnormal involuntary movements) and wearing off (the gradual return of symptoms as a dose of levodopa loses effectiveness) tend to occur earlier but they generally progress more slowly. This is thought to be due to the most commonly prescribed medication, levodopa, and for this reason, young onset is usually treated initially with alternatives to levodopa such as MAO-B inhibitors or dopamine agonists. Levodopa is generally only added in when other medications do not provide adequate symptom control.
Dystonia (involuntary muscle contractions causing abnormal movements and postures) is also a more common early motor symptom in early or young onset, whereas some of the non-motor symptoms that occur in older onset Parkinson’s, such as memory problems, are less common.
Discussing medication options with your doctor is important, together with dosage and timing, so that the best balance can be achieved for you. You may also be able to help your care team to optimise treatment by keeping a diary of what medications you have taken, how well they have worked and any side effects you have experienced. This can be particularly helpful if your doctor or neurologist changes.
Deep brain stimulation (DBS) has also been shown to be effective at an earlier stage of Parkinson’s if medication no longer controls motor symptoms so well, and you may want to discuss this option with your care team. See Deep brain stimulation (DBS).
Levodopa/carbidopa intestinal infusion delivered directly to your small intestine by a pump may also be an option to discuss with your doctor if oral medication is no longer managing symptoms well. See Continuous dopaminergic stimulation (CDS) [Continuous levodopa/carbidopa infusion].
Managing a neurological condition at a much earlier age and for a longer period of time, can lead to challenges relating to financial planning, career adjustments and family or parenting responsibilities. But being younger, means adapting to change such as physical limitations, within the workplace, leisure etc., can be easier.
One of the most important steps you can take is to prioritise what is important to you. Based on what you need and want, you could choose to focus on exercise, nutrition, leisure time, relationships, and emotional wellbeing, for example. Discussing these goals with those close to you can help you to prioritise and enable them to support you.