Parkinson’s disease is often diagnosed later in life — but not always. Early-onset Parkinson’s disease (also known as young-onset Parkinson’s) is a type that begins much sooner than expected. Noticing subtle movement changes at a young age can be an important step toward recognizing early-onset Parkinson’s disease.

“I was diagnosed at 47, about 15 years ago. It took forever to figure out what was going on. I’m slowly declining, but I’m fighting with everything I have,” wrote one MyParkinsonsTeam member.

Keep reading to learn more about early-onset Parkinson’s disease, its risk factors, and ways it differs from typical Parkinson’s.

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What Are the Symptoms of Early-Onset Parkinson’s Disease?

In Parkinson’s disease, dopamine-producing brain cells are progressively lost. Dopamine is a neurotransmitter (brain chemical) that plays an important role in movement and other brain functions. As dopamine levels drop, symptoms can appear and change over time.

Symptoms of early-onset Parkinson’s disease are similar to those of Parkinson’s diagnosed later in life. Motor (movement-related) symptoms include:

• Tremor, or involuntary shaking, often in the hands, arms, legs, or jaw
• Rigidity (stiffness) in the arms, legs, or trunk
• Bradykinesia (slowness of movement)
• Trouble with balance and coordination
• Dystonia (painful muscle cramps that can cause abnormal postures)

Nonmotor symptoms include:

• Depression, anxiety, and other changes in mood
• Sleep problems
• Cognitive (thinking) difficulties, such as problems with memory or learning
• Urinary problems or constipation

How Does Early-Onset Parkinson’s Compare to Typical Parkinson’s?

Early-onset Parkinson’s disease can differ in some ways from Parkinson’s diagnosed later in life. Understanding the following differences can help younger adults and their care teams plan for treatment and long-term needs.

• Earlier dystonia — Cramping and abnormal postures, such as twisting of the foot or tilting of the head, can happen earlier and more often in early-onset Parkinson’s.
• More movement complications from medication — People with early-onset Parkinson’s are more likely to develop dyskinesia (involuntary movements) and changes in how well levodopa controls symptoms over time.
• Nonmotor symptoms that may occur later — Memory loss, confusion, and dementia tend to be less common or develop later in younger people with Parkinson’s. Other nonmotor symptoms, including anxiety and depression, can still occur.
• Slower progression — Younger people tend to have fewer overlapping health problems and may be better able to participate in physical therapy. On average, motor symptoms also tend to progress more slowly in people whose Parkinson’s begins at a younger age, although progression varies widely from person to person.

What Are the Causes and Risk Factors for Early-Onset Parkinson’s Disease?

The cause of Parkinson’s is unknown. Researchers believe it may involve a combination of genetic and environmental factors.

In people with early-onset Parkinson’s, genetics may play a bigger role, especially if there’s a family history. Research has linked certain gene variants to Parkinson’s, including some forms that begin at a younger age. Genes linked to Parkinson’s include:

• GBA1
• SNCA
• PRKN
• PINK1

Having a genetic variant linked to Parkinson’s doesn’t always mean you’ll develop the disease. Genetic counseling can help you understand what genetic test results may mean for you and your family.

How Is Early-Onset Parkinson’s Disease Diagnosed?

To diagnose Parkinson’s at any age, a doctor, such as a movement disorder specialist, will first consider your medical history, family history, and symptoms. They will also perform a neurological exam to assess how your brain controls movement.

The doctor may check your coordination and look for tremor, slowness of movement, and rigidity. To check for rigidity, they may move a relaxed arm or leg to see how much the muscles resist.

No single test can confirm Parkinson’s. If your doctor needs more information, they may recommend a DaTscan, which provides images of the brain’s dopamine system and can support the diagnosis. Other imaging or tests may be used to rule out other conditions, if needed.

How Is Early-Onset Parkinson’s Disease Treated?

There’s currently no cure for early-onset Parkinson’s, but several treatments can help manage symptoms. Treatment options are similar for people with Parkinson’s regardless of their age at diagnosis.

Rehabilitation

Treatment may include a combination of physical, occupational, and speech therapies. These therapies can help people maintain movement, independence, and communication.

Exercise is also an important part of managing Parkinson’s. Regular exercise can help improve movement and nonmotor symptoms and support quality of life.

Doctors and researchers recommend exercising at higher intensities when it’s safe to do so, particularly for younger people and those in the early stages of Parkinson’s, because greater intensity may provide greater benefits. A physical therapist can help guide you. You can also ask your healthcare team about Parkinson’s-specific exercise programs in your area.

“My local YMCA started a Parkinson’s exercise class. I started this last year twice a week, and it’s helped me a lot,” wrote one MyParkinsonsTeam member.

Medications

Your doctor can work with you to choose medications based on your symptoms, treatment goals, and possible side effects. Medication options for early-onset Parkinson’s include:

• Levodopa and carbidopa (Crexont, Dhivy, Duopa, Rytary, Sinemet) — Levodopa is converted to dopamine in the brain and is combined with carbidopa to reduce certain side effects. Levodopa is the most effective medication for treating Parkinson’s motor symptoms.
• Monoamine oxidase-B (MAO-B) inhibitors — These medicines slow the breakdown of dopamine in the brain and help improve motor symptoms.
• Amantadine (Gocovri) — Amantadine can help treat Parkinson’s motor symptoms and is commonly used to reduce involuntary movements.
• Anticholinergics — These medications reduce the activity of acetylcholine, a brain chemical involved in movement. They may help with tremor, particularly in younger people, but are used carefully because they can cause side effects such as dry mouth, constipation, confusion, and memory problems.

You and your doctor can weigh the pros and cons of each based on your symptoms and health needs. People with early-onset Parkinson’s have more years in which they may develop motor complications such as dyskinesia and changes in how well levodopa controls symptoms over time.

More research is needed to determine the best treatment approach for early-onset Parkinson’s. Levodopa remains the most effective medication for Parkinson’s motor symptoms.

Surgery

Deep brain stimulation (DBS) may be an option for some people whose motor symptoms or medication-related complications are no longer adequately controlled with medication. During DBS, electrodes are surgically placed in specific areas of the brain and connected to a device that sends electrical signals to help control symptoms such as tremor, stiffness, and slowness. DBS can also help treat medication-related dyskinesia and “off” periods, but it doesn’t stop Parkinson’s from progressing.

Several MyParkinsonsTeam members who have had early-onset Parkinson’s for years are discussing DBS with their doctors. One shared, “I was diagnosed 10 years ago, and my symptoms are now to the point that I’m getting DBS later this year.”

Another member said, “I’ve had DBS for two years, and most symptoms I have right now are cognitive.”

Outlook and Challenges for Early-Onset Parkinson’s

Having Parkinson’s before age 50 comes with unique challenges. It can affect your family life, work, and finances differently than Parkinson’s diagnosed later in life. Depending on your age and circumstances, parenting young children may also be a concern.

Support groups can provide a place to discuss challenges and learn how others approach them. You can find groups through local or national Parkinson’s organizations, including the PMD Alliance Young Onset Parkinson’s Network, which offers opportunities to connect with others.

Because early-onset Parkinson’s begins at a younger age, you may live with and manage the condition for many years. Coping with its effects can be mentally and emotionally challenging. “The stress in my life, from childhood and from Parkinson’s, really has an effect on me and my symptoms, I think,” wrote one member.

Talk with your doctor if depression, anxiety, or stress is affecting your daily life or quality of life. They can help you find a mental health professional or other sources of support.