Understanding Parkinson’s disease

Parkinson’s is a progressive disease of the central nervous system. The condition is caused by a loss of cells in the area of the brain that produces dopamine. It’s usually diagnosed in people who are in their early 60s. People who are diagnosed before age 50 are said to have early onset Parkinson’s.

About 4 percent of the approximately 1 million Americans with Parkinson’s are diagnosed before age 50. That number may be higher because the disease is often underdiagnosed in younger people.

The symptoms of Parkinson’s disease are often the same, regardless of the age of diagnosis. That said, symptoms do vary from person to person.

Recent research suggests that nonmotor symptoms often happen first in younger patients. This includes:

  • loss of smell
  • constipation
  • REM behavior disorder
  • mood disorders, such as depression or anxiety
  • orthostatic hypotension, or low blood pressure when standing up

Other nonmotor symptoms include:

  • trouble sleeping, including sleeping too much during the day or too little at night
  • bladder problems
  • change in sex drive
  • increased saliva production
  • fluctuation in weight
  • visual disturbances
  • fatigue
  • cognitive issues, such as trouble remembering things or frequent confusion

Motor symptoms are common first symptoms in those of all ages. These can include:

  • resting tremor, or constant shaking movement even though your muscles are relaxed
  • slowed movement (bradykinesia)
  • rigid muscles
  • stooped posture
  • balance problems

It’s unclear exactly what causes Parkinson’s at any age. Genetic factors, environmental factors, or some combination of the two may play a role. This condition occurs when cells are lost in the part of the brain that produces dopamine. Dopamine is responsible for sending brain signals that control movement.

Certain genes are associated with early onset Parkinson’s.

According to the National Parkinson Foundation, studies show that 65 percent of people with Parkinson’s who experience onset before age 20 may do so because of a genetic mutation. This organization also suggests this mutation affects 32 percent of people who experience onset between age 20 and 30.

Environmental causes of the condition may include exposure to chemical toxins such as certain insecticides, fungicides, and herbicides.

The U.S. Department of Veterans Affairs recognizes Parkinson’s as a disease caused by exposure to Agent Orange. Agent Orange is a synthetic chemical herbicide that was used to spray vegetation and trees during the Vietnam War.

You may have a higher risk of developing Parkinson’s if you:

  • are a man
  • live in an area where certain organic or industrial pollutants exist
  • have a job that exposes you to toxic chemicals such as manganese or lead
  • have had a traumatic head injury
  • have been exposed to Agent Orange or other herbicides
  • have a job that exposes you to chemical solvents or polychlorinated biphenyls

There is no single test to detect Parkinson’s. A diagnosis may be difficult and take a while. The condition is usually diagnosed by a neurologist based on a review of your symptoms and a physical exam.

A DaTscan to visualize your brain’s dopamine system may help confirm diagnosis. Blood tests and other imaging tests, such as an MRI scan, don’t diagnose Parkinson’s. However, they may be used to rule out other conditions.

Parkinson’s treatment aims to slow the disease’s progression. Medication treatment options may include the following:

  • Levodopa is a chemical that’s converted to dopamine in the brain. People with early onset Parkinson’s may experience more negative side effects, such as involuntary movements.
  • MAO-B inhibitors can help reduce the breakdown of dopamine in the brain.
  • Catechol-O-methyltransferase inhibitors can help extend Levodopa’s effects on the brain.
  • Anticholinergics can help reduce tremors.
  • Amantadine may be used to improve muscle control and relieve stiffness.

Deep brain stimulation

Deep brain stimulation (DBS) is also considered a good option for people with early onset Parkinson’s. This is because people with early onset Parkinson’s are less likely to have other diseases that may cause complications.

DBS is a surgical procedure in which electrodes are placed in specific areas of your brain. These electrodes are connected to a generator. The generator is programmed to send electrical pulses to your brain.

The procedure may help alleviate the following symptoms:

  • tremor
  • rigidity
  • stiffness
  • slowed movement
  • difficulty walking

Caring for a loved one with early onset Parkinson’s can be difficult. If you’re a caregiver for someone with this condition, it’s important that you remember your own emotional and physical health.

Not only are you dealing with a difficult diagnosis, you’re also managing an increased number of responsibilities. Burnout is common in caregivers, so make sure you’re checking in with your own needs.

The Michael J. Fox Foundation Center for Parkinson’s Research recommends these tips for caregivers:

Join a support group

Participating in a support group can offer you an outlet for your fears, concerns, and frustrations. You may also learn about new medications, research, and coping tips.

Expand your medical team

Add as many experts to your healthcare team as you need to support you and your loved one. This includes therapists, nutritionists, and movement specialists.

Stay organized

Maintain a calendar to track doctor appointments, medication refills, and your own obligations.

Stay informed

Educate yourself so you know what to expect. This can help you plan ahead so you’re not caught off guard by new symptoms.

Watch for depression

Stay closely tuned to the moods of your loved one. Watch out for the first signs of depression and get help if needed. Signs include:

  • angry outbursts
  • appetite changes
  • sleep problems
  • anxiety
  • agitation
  • cognitive problems

Don’t overlook your own needs

You can’t take care of others if you don’t take care of yourself. Maintain a healthy diet and exercise regularly (even if it’s just taking a walk). Figure out what helps you de-stress. You may enjoy journaling, meditation, or yoga. Identify family members or friends who will step in when you need a break.

There isn’t a conclusive way to prevent Parkinson’s at any age. There are steps you can take that may help reduce your risk, however:

  • Drink caffeine. A study published in the Journal of Alzheimer’s Disease found that caffeine can help restore early motor and nonmotor symptoms tied to Parkinson’s.
  • Take anti-inflammatory drugs. A review of studies published by the American Academy of Neurology determined that anti-inflammatory drugs known as NSAIDs may help prevent Parkinson’s.
  • Watch your vitamin D levels. Many people with Parkinson’s don’t get enough vitamin D. Vitamin D supplementation may help reduce your risk.
  • Stay active. Exercise improves muscle stiffness, mobility, and depression in Parkinson patients. It may also help reduce the risk of getting the disease.

Early onset Parkinson’s is a serious chronic disease. Medications and lifestyle changes often relieve symptoms. They may also slow the disease’s progression.

Parkinson’s research is ongoing. There is hope that more effective medications will be developed, and that there will ultimately be a cure.