Parkinson’s striking younger Indians—what needs to be done – Firstpost

Once deemed a geriatric disorder, Parkinson’s disease (PD) is now emerging as a growing neurological threat among
India’s younger population with early-onset cases escalating at an alarming rate. In the absence of a definitive cure, neurologists are advocating for prompt diagnosis and a comprehensive multidisciplinary management strategy to alleviate symptoms and enhance patients’ quality of life.

The disease, a chronic and progressive neurodegenerative condition traditionally linked with aging, is witnessing a demographic shift. Alarming new data points to a sharp increase in early-onset PD in India, raising concerns that the country may be evolving into a global epicenter for this debilitating disorder.

Alarming projections and early-onset trends

A study published in the British Medical Journal predicts that by 2050, approximately 25.2 million individuals worldwide will be living with Parkinson’s disease—marking a 112% increase from 2021. Notably, South Asia, including India, is expected to account for 6.8 million of these cases. The study emphasizes that population aging is the primary contributor to this surge, followed by population growth and changes in prevalence rates. The projected prevalence is 267 cases per 100,000 individuals by 2050.

In India, PD prevalence ranges from 15 to 43 per 100,000 people. Alarmingly, the National Institute of Mental Health and Neurosciences (NIMHANS) noted in 2022 that nearly 40–45% of Indian PD patients experience the early onset of motor symptoms between the ages of 22 and 49—classifying them as early-onset Parkinson’s disease cases. This trend indicates that Indians are developing PD nearly a decade earlier than the global average.

Understanding Parkinson’s disease

Parkinson’s disease affects movement due to a dopamine deficiency, a vital neurotransmitter in the brain. Symptoms typically develop gradually and may begin with a barely noticeable tremor in one hand. While tremors are common, the disorder also causes stiffness and slowing of movement. Early signs include tremors, muscle rigidity, and difficulties with mobility. Non-motor symptoms may include loss of smell, constipation, and sleep disturbances.

Causes and risk factors

The exact cause of PD remains unknown, but several factors contribute to its development:

Genetic factors: Certain genetic mutations have been linked to PD. Having a close relative with the disease increases one’s risk.

Environmental factors: Exposure to toxins such as pesticides and herbicides may slightly increase the risk.

Age: The risk increases with age, typically affecting those 60 and older.

Men are more likely to develop PD than women

“Parkinson’s is not a single entity but includes other conditions that resemble PD. One is typical Parkinsonism, and the other is atypical Parkinsonism. This distinction is vital as typical Parkinsonism responds well to medication, whereas atypical forms progress more rapidly.” — Dr. Praveen Gupta, Principal Director & Chief of Neurology, Fortis Hospital

Importance of early diagnosis

Health experts say early detection of PD is crucial for managing symptoms effectively and improving quality of life.

“Parkinson’s is often misdiagnosed in its early stages because symptoms like stiffness and fatigue are mistaken for normal ageing or arthritis. Early detection through clinical evaluation and imaging can help initiate neuroprotective therapies that delay motor complications, such as slowness in daily activities, tremors in the hands and legs, and body rigidity. Advanced treatments like deep brain stimulation can offer significant relief when initiated promptly.” — Dr. Madhukar Bhardwaj, Director & HOD Neurology, Aakash Healthcare

Symptoms & importance of timely medical consultation

Symptoms of Parkinson’s typically worsen gradually, though the pace and severity of progression differ greatly from person to person. In advanced stages, individuals may lose the ability to walk or carry out daily activities independently. The disease is also associated with depression and cognitive issues, such as memory loss and difficulty thinking clearly.

Although Parkinson’s is not classified as a fatal illness, complications can be life-threatening. These may include respiratory issues, as weakened muscles impair swallowing and the ability to cough effectively.

“In neurological disorders, patients tend to delay seeking medical help compared to other physical illnesses. This delay increases the severity of the disease.” — Dr. Praveen Gupta

“The diagnosis of Parkinson’s disease remains clinical, with no confirmatory lab or imaging studies. Deep brain stimulation is reserved for patients unresponsive to medications, but the mainstay of treatment remains medical management.” — Dr. Neha Kapoor, Associate Director & Head of Neurology, Asian Hospital

Nutrition & psychological support

Nutrition and psychological care are crucial in managing Parkinson’s disease and supporting overall brain health.

“A nutrient-dense diet rich in antioxidants, omega-3 fatty acids, and dietary fiber is essential for brain health and symptom management in Parkinson’s. Equally important is strategic protein timing—especially for patients on Levodopa therapy—as it can significantly enhance the medication’s absorption and effectiveness.” — Dr. Rajas Deshpande, Consultant and Director – Neurology, Jupiter Hospital Baner, Pune

“Depression and anxiety are common in PD patients due to the chronic nature of the disease. Counseling and support groups are essential for helping both patients and caregivers cope.” — Dr. Neha Kapoor

Exercise: A critical element

Experts emphasise that exercise is often underestimated in Parkinson’s care.

“Many people underestimate the profound impact of exercise. It’s not just beneficial for physical well-being—it also helps rewire the brain. For individuals with Parkinson’s, consistent and targeted movement can enhance brain function and motor control. One promising technique is LSVT BIG therapy, which focuses on exaggerated, large-amplitude movements to help counteract stiffness and slowness.” — Dr. Madhukar Bhardwaj

Treatment options

While there is no cure for PD, treatment aims to alleviate symptoms through:

Medications: Drugs like Levodopa help manage motor symptoms by increasing dopamine levels.

Surgical interventions: Procedures like deep brain stimulation (DBS) have effectively reduced symptoms in advanced cases.

Lifestyle modifications: Regular exercise, a balanced diet, and physical therapy can improve mobility and overall well-being.