Age at Onset Influences Progression of Motor and Non-Motor Symptoms during the Early Stage of Parkinson's Disease: A Monocentric Retrospective Study

The interactions between the age at onset with other pathogenic mechanisms and the interplays between the disease progression and the aging processes in Parkinson's disease (PD) remain undefined, particularly during the first years of illness. Here, we retrospectively investigated the clinical presentation and evolution of the motor and non-motor symptoms and treatment-related complications during the first 5 years of illness in subjects categorized according to age at onset. A total of 131 subjects were divided into Early-Onset-PD (EOPD; onset <= 49 years), Middle-Onset-PD (MOPD; onset 50-69 years) and Late-Onset-PD (LOPD; onset >= 70 years). The T0 visit was set at the time of the clinical diagnosis; the T1 visit was 5 years (+/- 5 months) later. At T0, there were no significant differences in the motor features among the groups. At T1, the LOPD patients displayed a significantly higher frequency of gait disturbances and a higher frequency of postural instability. Moreover, at T1, the LOPD subjects reported a significantly higher frequency of non-motor symptoms; in particular, cardiovascular, cognitive and neuropsychiatric domains. The presented results showed a significantly different progression of motor and non-motor symptoms in the early course of PD according to the age at onset. These findings contribute to the definition of the role of age at onset on disease progression and may be useful for the pharmacological and non-pharmacological management of PD.

Automated summary

This study retrospectively investigated the clinical presentation and progression of Parkinson's disease (PD) during the first 5 years of illness in different age groups. The results showed significant differences in disease progression and non-motor symptoms among age groups in the early course of PD, with late-onset patients showing more pronounced gait disturbances and non-motor symptoms. These findings contribute to understanding the role of age at onset in PD progression and can be useful for managing the disease.