A comparison of clinical and pathological features of young‐ and old‐onset Parkinson's disease

TLDR

The study compared 46 young‑onset Parkinson’s patients (≤45 years) with 52 old‑onset patients (>70 years). Young‑onset patients showed more muscular stiffness, off‑period leg dystonia, and longer disease duration, while old‑onset patients more often had difficulty walking and rest tremor, yet both groups exhibited similar Lewy body pathology and overall disease processes.

Abstract

We compared 46 patients having onset of Parkinson9s disease before age 45 years with 52 having onset after age 70. Young-onset cases more often presented with muscular stiffness (43%) and old-onset with difficulty walking (33%). One-third of young-onset cases had off-period dystonia, mostly affecting the legs, but no dystonia was recorded in old-onset cases. Presentation with rest tremor occurred in 41% of young-onset and 63% of old-onset. There were no differences in the number of affected relatives, endocrine disease, personality characteristics, dementia, or dyskinesia. A pathological study of 12 young-onset and 22 old-onset cases showed 24% greater nigral cell loss in the young, but no differences in the basic Lewy body pathology. Median disease duration in young cases was 5 years longer in the clinical study and 12 years longer in the pathological study. These studies show that the Parkinson9s disease process is similar in young- and old-onset cases.