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Young onset

Parkinson’s can affect people of all ages. 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 young onset than in people who are diagnosed over the age of 40.

In YOPD 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 YOPD and older onset Parkinson’s. In YOPD motor fluctuations such as dyskinesia and wearing off 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, YOPD 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 is also a more common early motor symptom in YOPD. Some of the non-motor symptoms that occur in older onset Parkinson’s, such as memory problems, are less common in YOPD.

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 regular record 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).

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 is also helpful and enables them to support you.

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