Treatment Options For Early Onset Parkinsons Disease
Parkinsons treatment aims to slow the diseases progression. Medication treatment options may include the following:
- Levodopa is a chemical thats converted to dopamine in the brain. People with early onset Parkinsons 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 Levodopas effects on the brain.
- Anticholinergics can help reduce tremors.
- Amantadine may be used to improve muscle control and relieve stiffness.
Diagnosing Early Onset Parkinsons Disease
There is no single test to detect Parkinsons. 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 brains dopamine system may help confirm diagnosis. Blood tests and other imaging tests, such as an MRI scan, dont diagnose Parkinsons. However, they may be used to rule out other conditions.
Unique Characteristics Of Young
Although Parkinson’s is similar among people of all ages, those with young-onset PD generally have slower disease progression. They also tend to experience more side effects from dopaminergic medications and are more likely to have dyskinesias in response to the drug levodopa. Dyskinesias are abnormal, involuntary movements. They appear like a dance with wiggling movements of arms, legs, body or face.
Other problems associated with PD, such as memory loss, confusion, and problems with balance tend to occur less often in people with young-onset Parkinson’s. However, as with PD in older patients, the disease severity and symptoms vary from person to person.1,2
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Bryans Early Onset Parkinsons Diagnosis
Bryan is a 35-year-old nurse, rock climber, husband, and new father to a four-month-old baby boy. He is also someone who is living with YOPD. YOPD is defined as Parkinsons that is diagnosed before the age of 50 and includes about 10% of people living with PD. Younger people will experience the disease differently than those who are diagnosed older, in part due to their different life circumstances. Employment, new relationships, and parenthood add particular challenges that those who are diagnosed older may not have to navigate. When and how to disclose the diagnosis is also of particular concern.
Parkinsons Disease: Causes Symptoms And Treatments
Parkinsons disease is a brain disorder that causes unintended or uncontrollable movements, such as shaking, stiffness, and difficulty with balance and coordination.
Symptoms usually begin gradually and worsen over time. As the disease progresses, people may have difficulty walking and talking. They may also have mental and behavioral changes, sleep problems, depression, memory difficulties, and fatigue.
While virtually anyone could be at risk for developing Parkinsons, some research studies suggest this disease affects more men than women. Its unclear why, but studies are underway to understand factors that may increase a persons risk. One clear risk is age: Although most people with Parkinsons first develop the disease after age 60, about 5% to 10% experience onset before the age of 50. Early-onset forms of Parkinsons are often, but not always, inherited, and some forms have been linked to specific gene mutations.
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Causes Of Parkinson’s Disease
Parkinson’s disease is caused by a loss of nerve cells in part of the brain called the substantia nigra. This leads to a reduction in a chemical called dopamine in the brain.
Dopamine plays a vital role in regulating the movement of the body. A reduction in dopamine is responsible for many of the symptoms of Parkinson’s disease.
Exactly what causes the loss of nerve cells is unclear. Most experts think that a combination of genetic and environmental factors is responsible.
Living With Parkinson Disease
These measures can help you live well with Parkinson disease:
- An exercise routine can help keep muscles flexible and mobile. Exercise also releases natural brain chemicals that can improve emotional well-being.
- High protein meals can benefit your brain chemistry
- Physical, occupational, and speech therapy can help your ability to care for yourself and communicate with others
- If you or your family has questions about Parkinson disease, want information about treatment, or need to find support, you can contact the American Parkinson Disease Association.
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Study Variables And Outcomes
The study examined different time variables and their relation to PD progression. The five main time variables considered were age at PD onset, age at PD diagnosis, age at baseline, years since PD onset, and years since PD diagnosis. PD onset was defined as self-reported onset of motor symptoms while time variables related to age and diagnosis were defined based on central registers.
This study included symptom-based outcomes, HRQoL outcomes, and treatment outcomes. The symptom-based outcomes were investigated using the following scales Clinical Impression of Severity Index for Parkinson’s Disease with a total score ranging from 036, with higher scores indicating higher levels of disability), Modified Hoehn & Yahr staging , and Non-Motor Symptom Questionnaire . In addition, dystonia and daily dystonia time were evaluated along with freezing of gait and off fluctuations. The HRQoL outcomes were investigated using the Eight-item Parkinsons Disease Questionnaire and the EQ-5D-3 level version , including the EQ-5D-3L visual analogue scale . Treatment outcomes were extracted using data on filled prescriptions. The treatment outcomes included average daily levodopa dose, averaged LEDD and number of different dopaminergic agents the patient had been exposed to at a given visit. Current or former use of individual drugs or drug types within the group of dopaminergic agents were also considered as outcomes at baseline following the convention described in the previous section.
What Is The Prognosis And Life Expectancy For Parkinsons Disease
The severity of Parkinsons disease symptoms and signs vary greatly from person to peson, and it is not possible to predict how quickly the disease will progress. Parkinsons disease itself is not a fatal disease, and the average life expectancy is similar to that of people without the disease. Secondary complications, such as pneumonia, falling-related injuries, and choking can lead to death. Many treatment options can reduce some of the symptoms and prolong the quality of life.
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Do Only Old People Get Parkinson’s Disease
Although Parkinson’s disease is much more common in people who are older than age 50, it can affect people of all ages, including even children and teenagers.
Also, just because you’re older, it doesn’t mean you’ll get Parkinson’s most people never get it. Your age is only one factor in your risks for the condition.
Richard Drury / Stone / Getty Images
Changes In Cognition And Parkinsons Disease
Some people with Parkinsons may experience changes in their cognitive function, including problems with memory, attention, and the ability to plan and accomplish tasks. Stress, depression, and some medications may also contribute to these changes in cognition.
Over time, as the disease progresses, some people may develop dementia and be diagnosed with Parkinsons dementia, a type of Lewy body dementia. People with Parkinsons dementia may have severe memory and thinking problems that affect daily living.
Talk with your doctor if you or a loved one is diagnosed with Parkinsons disease and is experiencing problems with thinking or memory.
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Prevention Of Parkinsons Disease
Researchers dont know of any proven ways to prevent Parkinsons disease, but avoiding certain risk factors and adopting a healthy lifestyle may help reduce your risk.
Some studies have shown a diet high in antioxidants along with regular exercise may play a role in preventing Parkinsons. Other findings have suggested that compounds like caffeine, niacin, and nicotine may have a protective effect against Parkinsons disease.
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What Causes The Condition
Although there are several recognized risk factors for Parkinsons disease, such as exposure to pesticides, for now, the only confirmed causes of Parkinsons disease are genetic. When Parkinsons disease isnt genetic, experts classify it as idiopathic . That means they dont know exactly why it happens.
Many conditions look like Parkinson’s disease but are instead parkinsonism from a specific cause like some psychiatric medications.
Familial Parkinsons disease
Parkinsons disease can have a familial cause, which means you can inherit it from one or both of your parents. However, this only makes up about 10% of all cases.
Experts have linked at least seven different genes to Parkinson’s disease. They’ve linked three of those to early-onset of the condition . Some genetic mutations also cause unique, distinguishing features.
Idiopathic Parkinsons disease
Experts believe idiopathic Parkinsons disease happens because of problems with how your body uses a protein called -synuclein . Proteins are chemical molecules that have a very specific shape. When some proteins dont have the correct shape a problem known as protein misfolding your body cant use them and can’t break them down.
With nowhere to go, the proteins build up in various places or in certain cells . The buildup of these Lewy bodies causes toxic effects and cell damage.
The possible causes are:
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What Is Parkinson’s Disease
Parkinsons disease occurs when brain cells that make dopamine, a chemical that coordinates movement, stop working or die. Because PD can cause tremor, slowness, stiffness, and walking and balance problems, it is called a movement disorder. But constipation, depression, memory problems and other non-movement symptoms also can be part of Parkinsons. PD is a lifelong and progressive disease, which means that symptoms slowly worsen over time.
The experience of living with Parkinson’s over the course of a lifetime is unique to each person. As symptoms and progression vary from person to person, neither you nor your doctor can predict which symptoms you will get, when you will get them or how severe they will be. Even though broad paths of similarity are observed among individuals with PD as the disease progresses, there is no guarantee you will experience what you see in others.
Estimates suggest that Parkinsons affects nearly 1 million people in the United States and more than 6 million people worldwide.
For an in-depth guide to navigating Parkinsons disease and living well as the disease progresses, check out our Parkinsons 360 toolkit.
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Dr. Rachel Dolhun, a movement disorder specialist and vice president of medical communications at The Michael J. Fox Foundation, breaks down the basics of Parkinson’s.
Young Onset Parkinsons : An Introduction
Although the average age to develop Parkinsons is around 60, young onset Parkinsons occurs in 5-10% of people diagnosed. 20% are under the age of 50. Some challenges in Parkinsons are universal, regardless of age, but there are a number of issues specific to younger people.
Generally, Parkinsons proceeds more slowly in younger people. While no two people are the same, someone whose onset age is 40 can expect to work for another 15-20 years on average. For someone with an onset age of 60, the average figure would be half that. These figures are based on the kinds of treatment available today. Future treatment will be even more effective in prolonging the productive life of people with Parkinsons.
Larry Gifford hosts a panel discussion on Living Well with Young Onset Parkinsons in May of 2020.
The following characteristics tend to be present in young onset Parkinsons:
- Young onset Parkinsons is less likely to lead to dementia and balance problems
- It is more likely to include focal dystonia, which is cramping or abnormal posturing of one part of the body.
- Younger people are more sensitive to the benefits of Parkinson medications, but they tend to experience the dyskinetic side effects of levodopa sooner than older people.
- They also tend to experience dose-related fluctuations at an earlier stage of the disease, including wearing off* and the on-off effect. See Parkinson Canada Information Sheet, Parkinsons Medications: What you need to know!
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Circumstances And Societal Engagement In Yopd And Implications For Management
In general, people with YOPD tend to have different family and societal engagements to those with late-onset PD. For example, most people diagnosed with YOPD will have a job, whereas some people with late-onset PD have already retired. Additionaly, it is not unusual that people with YOPD have young children , or may want to start a family.
Eat Healthy Meals Throughout The Day
- Consuming a variety of foods from all five food groups provides consistent energy and keeps your immune system healthy. Focus on eating a minimum of five fruits and vegetables each day, eating a variety of high fiber foods, and staying hydrated, all of which help prevent constipation, which is often an issue for people diagnosed with YOPD.
- Watch this to learn how to use nutrition to help you live well with Parkinsons.
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How Do I Know If I Have Rbd
As people are not aware of their actions during RBD episodes, it is difficult to notice the disorder on your own. However, you might notice things when you wake up, such as objects in your surroundings that have been disturbed during the night. Hitting objects could also wake you up. More typically, your bed partner will report symptoms such as strong movement or speaking. It is usually possible to wake up during the episodes, where people are generally coherent, alert, they remember their dreams and can relate the body movements or gestures with their dreams.
For an RBD diagnosis, please consult a physician specialised in sleep who will evaluate the degree of probability and could eventually initiate diagnostic measures in a sleep laboratory where your body functions are monitored during the different phases of sleep.
How Does This Condition Affect My Body
Parkinsons disease causes a specific area of your brain, the basal ganglia, to deteriorate. As this area deteriorates, you lose the abilities those areas once controlled. Researchers have uncovered that Parkinsons disease causes a major shift in your brain chemistry.
Under normal circumstances, your brain uses chemicals known as neurotransmitters to control how your brain cells communicate with each other. When you have Parkinsons disease, you dont have enough dopamine, one of the most important neurotransmitters.
When your brain sends activation signals that tell your muscles to move, it fine-tunes your movements using cells that require dopamine. Thats why lack of dopamine causes the slowed movements and tremors symptoms of Parkinson’s disease.
As Parkinson’s disease progresses, the symptoms expand and intensify. Later stages of the disease often affect how your brain functions, causing dementia-like symptoms and depression.
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Support For People Living With Parkinsons Disease
While the progression of Parkinsons is usually slow, eventually a persons daily routines may be affected. Activities such as working, taking care of a home, and participating in social activities with friends may become challenging. Experiencing these changes can be difficult, but support groups can help people cope. These groups can provide information, advice, and connections to resources for those living with Parkinsons disease, their families, and caregivers. The organizations listed below can help people find local support groups and other resources in their communities.
Genetics In Yopd And Its Implications For Management
The genetic background of PD is gradually being revealed and consists of the spectrum from common variants that have small contributions to an increased vulnerability, to true monogenic forms . Some of the genes that previously received a PARK locus symbol are in fact unconfirmed, are risk alleles, or if mutated give rise to a more complex phenotype. A new nomenclature of genetic movement disorders, including PD, was recently proposed and has tried to deal with these complexities . Here, we focus on the confirmed genes that can be considered monogenic forms of PD. These mainly include the dominant genes SNCA, LRRK2, GBA, and VPS35, and the recessive genes Parkin, PINK1, DJ1. The common picture from the literature is that PD patients with a mutation in one of these genes present at an earlier age, particularly for the recessive genes and SNCA . So, vice versa, if a PD patient presents at a young age, the option of a genetic etiology is often considered. While next generation sequencing platforms have simplified screening the relevant genes, we have to critically address the question: what is the actual benefit of genetic testing in YOPD?
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Medicines For Parkinsons Disease
Medicines can help treat the symptoms of Parkinsons by:
- Increasing the level of dopamine in the brain
- Having an effect on other brain chemicals, such as neurotransmitters, which transfer information between brain cells
- Helping control non-movement symptoms
The main therapy for Parkinsons is levodopa. Nerve cells use levodopa to make dopamine to replenish the brains dwindling supply. Usually, people take levodopa along with another medication called carbidopa. Carbidopa prevents or reduces some of the side effects of levodopa therapy such as nausea, vomiting, low blood pressure, and restlessness and reduces the amount of levodopa needed to improve symptoms.
People living with Parkinsons disease should never stop taking levodopa without telling their doctor. Suddenly stopping the drug may have serious side effects, like being unable to move or having difficulty breathing.
The doctor may prescribe other medicines to treat Parkinsons symptoms, including:
- Dopamine agonists to stimulate the production of dopamine in the brain
- Enzyme inhibitors to increase the amount of dopamine by slowing down the enzymes that break down dopamine in the brain
- Amantadine to help reduce involuntary movements
- Anticholinergic drugs to reduce tremors and muscle rigidity
Is There A Way To Slow The Progress Of Parkinson’s
Parkinson’s disease is a progressive disorder, which means its symptoms worsen slowly over time. There is no cure for Parkinson’s disease yet and no known way to slow its progress.
But there are treatments and medications that can control or reduce the symptoms and help people live productive lives. Some research suggests that regular exercise may slow the progress of Parkinson’s. Physical activity can also alleviate stiffness and other symptoms.
There are other things a person can do to feel better after a diagnosis of Parkinson’s, such as joining social support groups and learning as much as possible about the disease. It’s also important to make the home safer and less cluttered, since a person with Parkinson’s is more likely to fall.
While it’s not always easy, neurologists say a positive mindset can also help.
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