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

Neurology. 1988 Sep;38(9):1402-6. doi: 10.1212/wnl.38.9.1402.


We compared 46 patients having onset of Parkinson's 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 Parkinson's disease process is similar in young- and old-onset cases.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Dyskinesia, Drug-Induced / complications
  • Female
  • Humans
  • Levodopa / adverse effects
  • Levodopa / therapeutic use
  • Male
  • Middle Aged
  • Muscular Diseases / complications
  • Parkinson Disease / complications
  • Parkinson Disease / genetics
  • Parkinson Disease / pathology
  • Parkinson Disease / physiopathology*
  • Personality
  • Substantia Nigra / pathology


  • Levodopa