Early-onset vs. Late-onset Parkinson's disease: A Clinical-pathological Study

Can J Neurol Sci. 2016 Jan;43(1):113-9. doi: 10.1017/cjn.2015.244. Epub 2015 Jul 20.


Background: Several studies have compared early-onset Parkinson disease (EOPD) and late-onset Parkinson disease (LOPD) but most are not based on autopsy confirmed cases.

Methods: We compared clinical and pharmacological profiles, time to reach irreversible Hoehn and Yahr (H&Y) Stage 3 and levodopa motor complications in autopsy confirmed EOPD and LOPD cases.

Results: At first clinic visit EOPD cases were younger but had longer disease duration and they died at a younger age (all p<0.0001). Anti-Parkinsonian drug use, including levodopa, was significantly delayed in EOPD. Lifetime use of amantadine (p<0.05) and dopamine agonists (p<0.01) were higher in EOPD. While lifetime use of levodopa was similar in the two groups, levodopa was used for a significantly longer period by EOPD (p< 0.0001). EOPD had a higher cumulative incidence of dyskinesias (p<0.01), wearing-off (p<0.01), and on-off (p<0.01). However, the time to dyskinesia onset was similar in the two groups. The threshold to wearing-off was much longer in EOPD (p<0.01). H&Y stage profile at first visit was similar in the two groups. The duration from disease onset to reach irreversible H&Y stage 3 was significantly longer in EOPD.

Conclusions: Our observations indicate that progression of PD is slower in EOPD and suggest that the pre-clinical interval in this group is longer. These findings can be used for case selection for drug trials and studies of the pathogenesis of PD.

Keywords: Age of Onset; Early-onset; Late-Onset; Parkinson disease.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age Factors
  • Age of Onset
  • Aged
  • Aged, 80 and over
  • Antiparkinson Agents
  • Disease Progression*
  • Dyskinesias / drug therapy
  • Dyskinesias / epidemiology
  • Dyskinesias / etiology
  • Dyskinesias / physiopathology*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Parkinson Disease / complications
  • Parkinson Disease / drug therapy
  • Parkinson Disease / epidemiology
  • Parkinson Disease / physiopathology*
  • Severity of Illness Index


  • Antiparkinson Agents