Impact of age at onset on symptom profiles, treatment characteristics and health-related quality of life in Parkinson’s disease

• Published in: Scientific reports 2022-01, Vol.12 (1), p.526-13, Article 526
• Main Authors: Raket, Lars Lau, Oudin Åström, Daniel, Norlin, Jenny M., Kellerborg, Klas, Martinez-Martin, Pablo, Odin, Per
• Format: Article
• Language: English
• Subjects: 631/378/2632/1323; 692/617/375; Age; Age of Onset; Aged; Aged, 80 and over; Aging; Antiparkinson Agents - therapeutic use; Clinical Medicine; Cohort Studies; Disease Progression; Drug development; Dyskinesia; Female; Humanities and Social Sciences; Humans; Klinisk medicin; Levodopa; Levodopa - therapeutic use; Longitudinal Studies; Male; Medical and Health Sciences; Medical treatment; Medicin och hälsovetenskap; Middle Aged; Movement disorders; multidisciplinary; Neurodegenerative diseases; Neurologi; Neurology; Parkinson Disease - physiopathology; Parkinson Disease - psychology; Parkinson's disease; Patients; Phenotypes; Population studies; Quality of Life; Science; Science (multidisciplinary); Sweden - epidemiology
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-021-04356-8

Parkinson’s disease (PD) is typically considered an age-related disease, but the age at disease onset can vary by decades between patients. Aging and aging-associated diseases can affect the movement system independently of PD, and advanced age has previously been proposed to be associated with a more severe PD phenotype with accelerated progression. In this work, we investigated how interactions between PD progression and aging affect a wide range of outcomes related to PD motor and nonmotor symptoms as well as Health Related Quality of Life (HRQoL) and treatment characteristics. This population-based cohort study is based on 1436 PD patients from southern Sweden followed longitudinally for up to approximately 7.5 years from enrollment (3470 visits covering 2285 patient years, average follow-up time 1.7 years). Higher age at onset was generally associated with faster progression of motor symptoms, with a notable exception of dyskinesia and other levodopa-associated motor fluctuations that had less severe trajectories for patients with higher age at onset. Mixed results were observed for emergence of non-motor symptoms, while higher age at onset was generally associated with worse HRQoL trajectories. Accounting for these identified age-associated differences in disease progression could positively impact patient management and drug development efforts.