Age

Most cases of Parkinson’s disease are seen in the elderly. In the United States about 1 out of ever 100 people over the age of 60 years has Parkinson’s disease. This incidence varies across the globe and even among certain communities as discussed below. The number of people living with Parkinson’s disease has increased over the years but this may not be necessarily due to a rise in the percentage of people developing PD. Instead this has to do with a longer life expectancy. Modern medicine, better living conditions and accessibility to health care services means that the “older live longer”. Naturally the number of people living with Parkinson’s disease has increased accordingly. This is further reflected in the difference of prevalence where there is now about 1 million more people living with Parkinson’s disease in the United States compared to 2005 when there was only about 500,000 Americans with PD.

Gender

Parkinson’s disease affects both men and women. It is, however, more common in men and in some countries like in the  United States this may be as much as 1.5 times. This could correlate with certain risk factors like exposure to pesticides and industrial pollutants which may be associated with more male-dominated jobs. However, with more women entering the workplace and having a similar exposure, not to mention the non-occupational exposure, it seems that men are at greater risk for unknown reasons.

Nationality and Ethnicity

The incidence of Parkinson’s disease varies across the globe. However, this distribution may not be as simple as a geographical or ethnic factor. It is known that the Parkinson’s disease is more prevalent in North America and Europe than in Asia and West Africa. However, certain findings like that of the Parsi community in India indicates that this may not just be a geographical difference. The Parsi community in Mumbai has the world’s highest incidences of Parkinson’s disease where it affects about 328 out of every 100,000 people despite living in a country, India, with one of the world’s lowest incidence of PD (70 out of 100,000).

Family History and Genetic

Despite the focus on a family history and genetics, it is believed this accounts for less than 5% of cases. More genes are being identified in familial PD, like the recent VPS35 genetic mutation, but its role is sometimes overstated and hyped in the media. There is no evidence of any genetic mutation or strong family history in the majority of Parkinson’s disease patient although family history is an accepted risk factor. This is further supported by the fact that the incidence in monozygotic and dizygotic twins is about the same. Had genetics been a major factor, the incidence would have been higher in the monozygotic twins.

The Parkinson’s Patient

Based on these factors, once could surmise that the person who is at greatest risk would be :

• Over the age of 60
• Male
• Living in North America
• From a family with a strong history of PD

However, with Parkinson’s disease the incidence and risk factors are not as conclusive as one would think. It is safe to say that in the backdrop of the unidentified causes in the majority of PD cases, the epidemiology has not provided definitive risk factors apart from age.

Early onset of Parkinson’s disease (YOPD or young onset of Parkinson’s disease) is not common but can occur as early as the teen years. It may often be missed at the onset and early stages of Parkinson’s disease may be misdiagnosed for other conditions like dystonia, multiple sclerosis and even alcohol or drug abuse. Often cases of Parkinson’s disease in teens or young adults (within their 20s) may be missed altogether for years as the sufferer attempts to hide their symptoms and cope with mild tremors and poor coordination without alerting a medical professional.

Young Onset Parkinson’s Disease Treatment

Treatment for early onset of Parkinson’s disease (teens, 20s, 30s) may not be the same as Parkinson’s disease in the more senior years. The use of levodopa is limited in young sufferers of Parkinson’s and reserved for the later years. Other treatments are usually advisable in a younger sufferer due to the side effects of levodopa, which has been shown to be higher when used in young onset of Parkinson’s disease. The higher incidence of depression in young onset of Parkison’s disease has to also be considered in the therapeutic protocol as the depression can affect the socioeconomic aspects of the sufferer.

Juvenile Parkinson’s Disease

Juvenile Parkinson’s disease is rare but has been reported to occur in children under the age of 10 years. Unlike other neurological and musculoskeletal disorders in children, juvenile Parkinson’s disease is clearly identifiable due to the changes in posture and stooped gait typical of Parkinson’s disease. These characteristic symptoms of Parkinson’s disease may not be as clearly evident in older children and young adults suffering with young onset of Parkinson’s disease (YOPD).

While there is no clear genetic link for the development of Parkinson’s disease, any person suspecting the development of this condition should seek medical attention immediately. A thorough case history, neurological and musculoskeletal examination and further diagnostic testing will allow your medical doctor to confirm or exclude Parkinson’s disease as a differential diagnosis.