Early-Onset Parkinson’s is Increasing
Parkinson’s disease is commonly associated with older age, but the condition can also affect people much earlier in life. An estimated 5% to 10% of people diagnosed with Parkinson’s develop the disease before reaching age 50. This form is often referred to as early-onset Parkinson’s disease (EOPD).
A Parkinson’s diagnosis during the 20s, 30s, or 40s can bring challenges that are very different from those faced later in life. Younger adults may be building careers, supporting children, planning for retirement, or managing other major responsibilities when symptoms begin. As the disease progresses, it can influence employment, finances, family life, relationships, emotional wellbeing, and long-term planning.
Understanding how frequently Parkinson’s occurs in younger adults, and how those numbers are changing around the world, is therefore important for researchers, healthcare providers, policymakers, and people living with the disease.
A recent study published in npj Parkinson’s Disease examined the worldwide burden of early-onset Parkinson’s over more than three decades. Using data from the Global Burden of Disease Study 2021, researchers analyzed trends across 204 countries and territories between 1990 and 2021.
The results suggest that the global burden of Parkinson’s among adults ages 20 to 49 has increased substantially.
A Significant Increase in Early-Onset Parkinson’s
Researchers looked at several measures to understand how EOPD has changed over time. These included:
Incidence: the number of new cases occurring each year.
Prevalence: the number of people living with the disease.
Years lived with disability: a measure used to estimate the impact a disease has on people's daily lives and functioning.
Across the study period, all three measures increased considerably.
In 1990, there were approximately 28,000 new cases of early-onset Parkinson’s each year among adults ages 20 to 49. By 2021, that figure had increased to approximately 81,000 cases annually.
The number of people living with EOPD also grew substantially, from around 190,000 in 1990 to nearly 484,000 in 2021.
Some of this increase can be explained by global population growth. There are simply more people in the world today than there were in 1990. However, the researchers also examined age-standardized rates, which help account for differences in population size and age distribution.
Those adjusted rates increased as well. In other words, the findings suggest that the change cannot be explained solely by having a larger global population.
People in Their 40s Account for Much of the Increase
Although the study focused on adults between ages 20 and 49, the likelihood of developing Parkinson’s varied considerably within that age range.
As expected, rates were much higher among people approaching their 50s than among people in their early 20s. Parkinson’s generally becomes more common as people age, even though early-onset disease occurs before age 50.
Interestingly, the fastest growth during the study period occurred among people in the oldest age group within the EOPD category.
This suggests that the overall increase in early-onset Parkinson’s is being driven in large part by adults in their late 40s.
The Trend Looks Different Around the World
The increase in early-onset Parkinson’s was not uniform across countries or regions.
In 2021, some of the highest rates were reported in Andean Latin America, including countries such as Peru, Bolivia, and Ecuador. East Asia, particularly China, also had relatively high rates.
More than 170 of the 204 countries and territories included in the analysis experienced an increase in age-standardized EOPD rates.
The strongest increases were generally seen in middle-income and upper-middle-income countries, with particularly notable growth in parts of East Asia and Andean Latin America. China and Norway were among the countries with some of the fastest increases in rates.
There were exceptions to the broader global trend. High-income North America, Central Europe, and Central Asia did not follow the same pattern of increasing rates. High-income North America, in particular, experienced a slight decline in its age-standardized rate.
These differences raise important questions about why early-onset Parkinson’s is changing differently from one part of the world to another.
Could Environmental Exposure Play a Role?
One particularly interesting finding involved pesticide use.
The researchers found an association between higher national pesticide use per unit of agricultural land and higher rates of early-onset Parkinson’s. Countries and regions with substantial agricultural activity, including parts of Andean Latin America and China, also reported relatively high rates of EOPD.
However, this finding needs to be interpreted carefully.
An association between pesticide use and Parkinson’s rates does not establish that pesticides caused the increase in early-onset Parkinson’s. Many factors can differ between countries, including healthcare access, occupational exposures, environmental conditions, diagnostic practices, population characteristics, and other potential risk factors.
Still, the finding is consistent with a larger body of research investigating possible connections between Parkinson’s disease and exposure to certain environmental chemicals.
The study therefore adds to the argument for continuing to investigate environmental factors that might contribute to Parkinson’s risk, particularly among people who develop the disease at a relatively young age.
Men Had Higher Rates Than Women
The study also found a notable difference between men and women.
Men experienced early-onset Parkinson’s at approximately 1.5 times the rate of women, and the difference appeared to increase over the study period.
There may be several possible explanations for this pattern. The researchers point to differences in occupational exposure, including greater exposure among men to pesticides, industrial chemicals, and heavy metals in some settings.
Hormonal differences may also play a role. Researchers have previously explored whether estrogen could provide some degree of protection against Parkinson’s disease, although the reasons for the sex difference are complex and are not fully understood.
More research is needed before these potential explanations can be established with confidence.
Why Is the Number of Cases Increasing?
The study does not provide a single explanation for the worldwide increase in early-onset Parkinson’s.
Some of the growth may reflect improvements in healthcare and diagnosis. As healthcare systems become better equipped to recognize Parkinson’s symptoms, more people may receive an accurate diagnosis. Improvements in treatment and medical care may also mean that people are living longer with the disease, increasing the number of people counted as living with EOPD at any given time.
At the same time, the increase in age-standardized rates suggests that population growth alone does not explain the trend.
Environmental exposures, changes in lifestyle, genetics, improved disease recognition, and other factors may all contribute. Determining how much each factor matters remains an important area for future research.
Key Findings at a Glance
The study's major findings include:
The global burden of early-onset Parkinson’s among adults ages 20 to 49 more than doubled between 1990 and 2021.
Annual new cases increased from approximately 28,000 to approximately 81,000.
The number of people living with EOPD increased from about 190,000 to nearly 484,000.
More than 170 of 204 countries and territories experienced increasing age-standardized rates.
The largest increases occurred in several middle-income and upper-middle-income countries.
Andean Latin America and East Asia had some of the highest rates in 2021.
Higher national pesticide use was associated with higher EOPD rates.
Men experienced early-onset Parkinson’s at approximately 1.5 times the rate of women.
High-income North America, Central Europe, and Central Asia were among the regions that did not follow the broader pattern of increasing rates.
What These Findings Mean for People Living With Parkinson’s
Perhaps the most important takeaway is that Parkinson’s disease is not exclusively a condition of older adulthood.
For someone diagnosed in their 30s or 40s, Parkinson’s can potentially mean living with the disease for many decades. That makes early recognition, appropriate treatment, mental health support, rehabilitation, workplace resources, and long-term planning especially important.
The findings also reinforce the need for greater awareness among both healthcare professionals and the general public. Symptoms of Parkinson’s in a younger person may not immediately be recognized as Parkinson’s, potentially delaying diagnosis and access to appropriate care.
At the same time, this study should not be interpreted as proving that a particular environmental exposure causes Parkinson’s in an individual. Its purpose was to describe global patterns and changes over time, not to determine the cause of individual cases.
Looking Ahead
The growing global burden of early-onset Parkinson’s highlights an important area for continued research.
Scientists still need to better understand why some people develop Parkinson’s at a young age, how genetic and environmental factors interact, and why rates differ so substantially between countries and populations.
Future research may also help clarify the role of environmental exposures such as pesticides and industrial chemicals while identifying other potentially modifiable risk factors.
For people living with Parkinson’s today, the study offers a broader message: Parkinson’s can affect people during the most active and demanding stages of adulthood, and those living with early-onset disease deserve research, healthcare, and support services that reflect their unique needs.
Greater awareness and earlier recognition can help ensure that younger adults with Parkinson’s are not overlooked, and continued research can help us understand why the burden of early-onset disease appears to be growing worldwide.
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