As shown in an analysis of the course of PD in five groups of patients who developed the disease at different ages, from the youngest (24–53 years, left) to the oldest (73–80 years), a younger onset of PD is typically associated with a longer disease course, compared with those who develop the disease later in life.3 While the rate of progression can vary greatly between individuals during the earlier stages of PD, the late stage tends to be characterised by a more fixed and rapid progression as the disease spreads into the cortical regions of the brain.3

 

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2.Parkinson’s UK website. www.parkinsons.org.uk. Accessed January 2025.

3.Kempster PA, O’Sullivan SS, Holton JL, et al. Relationships between age and late progression of Parkinson’s disease: a clinico-pathological study. Brain 2010; 133 (Pt 6): 1755–1762.

4.Williams-Gray CH, Mason SL, Evans JR, et al. The CamPaIGN study of Parkinson’s disease: 10-year outlook in an incident population-based cohort. J Neurol Neurosurg Psychiatry 2013; 84 (11): 1258–1264.

5.Gonzalez MC, Dalen I, Maple-Grødem J, et al. Parkinson’s disease clinical milestones and mortality. NPJ Parkinsons Dis 2022; 8 (1): 58.

6.Eggers C, Pedrosa DJ, Kahraman D, et al. Parkinson subtypes progress differently in clinical course and imaging pattern. PLoS One 2012; 7 (10): e46813.

7.Fernandes GC, Socal MP, Schuh AF, Rieder CR. Clinical and epidemiological factors associated with mortality in Parkinson’s disease in a Brazilian cohort. Parkinsons Dis 2015; 2015: 959304.

8.Akbar U, McQueen RB, Bemski J, et al. Prognostic predictors relevant to end-of-life palliative care in Parkinson’s disease and related disorders: a systematic review. J Neurol Neurosurg Psychiatry 2021; 92 (6): 629–636.

9.Trevisan L, Gaudio A, Monfrini E, et al. Genetics in Parkinson’s disease, state-of-the-art and future perspectives. Br Med Bull 2024; 149 (1): 60–71.