Kumar, Kishore R.

Background Parkinson's disease (PD) typically presents after age 60; however, approximately 10% of individuals experience early-onset PD (EOPD), with symptoms beginning between ages 21 and 50. Beyond motor and non-motor symptoms, PD can impact personal relationships through stigma, social isolation, and emotional burden. This study aims to examine the influence of PD on relationship outcomes such as divorce or separation. Methods This exploratory study analyzed data from the Fox Insight cohort, an online longitudinal research initiative supported by The Michael J. Fox Foundation. We included 470 individuals with self-reported PD who had complete data on marital status (“married” or “divorced”) and age at PD onset. Participants were categorized as having EOPD (<50 years) or late-onset PD (≥50 years). Chi-square tests assessed the association between PD onset group and marital status. A binary logistic regression model further evaluated gender and onset age as predictors of marital status in a subset of 330 participants. Results A significant association was found between PD onset group and marital status, with a higher divorce rate among the EOPD group (17.5%; 7/40) compared to late-onset PD (6.1%; 26/430) (p = 0.017). Logistic regression revealed no statistically significant predictors, though trends suggested lower odds of divorce in men and those with late-onset PD. Conclusion This exploratory analysis identified a potential association between early PD onset and higher divorce rates; however, with only 7 events in 40 EOPD participants, this finding is inherently unstable and should be regarded as hypothesis-generating only. Confirmation in larger, longitudinal cohorts is required before any conclusions can be drawn.

Pregnancy in women with early-onset Parkinson’s disease (PD) is likely to have a higher frequency given the trend toward increasing maternal age, thus resulting in a greater overlap time between childbearing age and PD risk. Deep brain stimulation (DBS) therapy is nowadays offered to PD patients at earlier stage of the disease, when women can still be pre-menopausal. However, few data are available about DBS safety during pregnancy. From a review of the available literature, only one article was published on this topic so far. Therefore, we have developed a clinical consensus on the safety of DBS during pregnancy in PD patients.

ABSTRACT Background Early‐onset Parkinson's disease (EOPD)/young‐onset Parkinson's disease (YOPD) is defined as Parkinson's disease (PD) with an age at onset (AAO) after age 21 years but before the usual AAO for PD. Consensus is lacking, and the reported maximal age for EOPD/YOPD has varied from 40 to 60 years, leading to a lack of uniformity in published studies and difficulty in harmonization of data. EOPD and YOPD have both been used in the literature, somewhat interchangeably. Objective To define the nomenclature and AAO cutoff for EOPD/YOPD. Methods An extensive review of the literature and task force meetings were conducted. Conclusions were reached by consensus. Results First, the literature has seen a shift from the use of YOPD toward EOPD. This seems motivated by an attempt to avoid age‐related stigmatization of patients. Second, in defining EOPD, 56% of the countries use 50 or 51 years as the cutoff age. Third, the majority of international genetic studies in PD use an age cutoff of younger than 50 years to define EOPD. Fourth, many studies suggest that changes in the estrogen level can affect the predisposition to develop PD, making the average age at menopause of 50 years an important factor to consider when defining EOPD. Fifth, considering the differential impact of the AAO of PD on professional and social life, using 50 years as the upper cutoff for the definition of EOPD seems reasonable. Conclusions This task force recommends the use of EOPD rather than YOPD. It defines EOPD as PD with AAO after 21 years but before 50 years.