following is loosely connected to this discussion. thought a few in this group would be interested in these statistics:
US Vital Statistics

http://www.cdc.gov/nchs/data/hus/hus10_InBrief.pdf


http://www.cdc.gov/nchs/data/hus/hus10.pdf

Lindy, I am not explaining myself well enough, since you are not understanding what I am suggesting. You say, " a lot of them are mentally and physically intact, and quite spry. My lady at the bus stop was one of those people. She had a little shake in her hand, but in conversation was pretty clear that she did not have PD, and in fact I could see that she did not.". This only shows the healthy end of the graph, the fortunate few who reach a very old age before whatever causes PD eg a porous BBB? causes PD symptoms. I am not saying all old people will show PD symptoms before they die. Highlighting healthy people at the top of the graph who are not showing PD symptoms, like your 81 year old,lady, only confirms the graph, There will be a few folk who are lucky enough to reach a ripe old age without PD.
The fact that you can get 2 sisters, who die on different years again only demonstrates the graph. One sister is the fortunate one who stays on the healthy non PD side of the graph and probably dies of a heart attack long before she deteriorates more to the point where she shows PD. The other one has a deficient BBB?? say, and shows symptoms at a much earlier age. It is not mandatory for sisters to die on the same day. They will each have their own medical history.

"Does the aging come first heralding the illness?
You have to talk about the symptoms of PD. They will show when the organ or organs which cause these symptoms detetriorate to a point below the threshold point. Then a 40 year old weill appear aged, walking with a shuffle, falling frequently, struiggling to fasten his buttons etc. To the ouitside world, he will appear to have aged prematurely. But he will mirror the actions of a 90 year old with a similar time since diagnosis. If all this was true, the symptoms of aging would be the same as what we call PD, which as far as I can see, they are.
But rather than have such hypothetical discussions, I would rather investigate whether PD medication could activate an old age pensioner, who is showing classic symptoms of PD. I am not sold on this theory, just acting as a devils agent, and arguing that side of the debate.
Ron

Any hypothesis into the etiology of PD needs to explain the fact that the incidence of the disease increases dramatically with age.

We need data. My starting point is a paper by the Canadian Institute of Actuaries [1]. This gives what I think is the most accurate values for the incidence of Parkinson's by age.

On page 107 is a table showing the incidence rates of PD per 1000 males. I use the raw observed rate for men. The figures for women are given as a percentage of the male rate.

Age Male Female
42 0.027 80%
47 0.0583 80%
52 0.1653 80%
57 0.3880 75%
62 0.6715 70%
67 1.3403 65%
72 1.8993 60%
77 2.5467 55%
82 3.5536 55%
87 6.1474 55%

It is worth noting:
- the authors take the view that the incidence rate does not plateau in the 80s, as has been mentioned elsewhere, but that it continues to accelerate in very old age;
- the numbers are just estimates of the "true" value; those at the extreme young and old ends are likely to be less accurate because the sample size is small.

Let's see how we can make use of these numbers to throw some light on Ron's question.

Example hypothesis: your genes or something that happens at a young age determines when you get PD. Assuming people are distributed according to a normal distribution (bell curve), the whole story is told by just two parameters: the mean (average) and the standard deviation (spread). We can use these values to predict the incidence, and we can adjust them to see if we can match the data.


Age........42... 47... 52... 57... 62... 67... 72... 77... 82... 87
Incidence 0.027 0.058 0.165 0.388 0.672 1.340 1.899 2.547 3.554 6.147
predicted 0.034 0.074 0.153 0.300 0.561 0.996 1.678 2.685 4.080 5.887
Error % 25.178 26.461 -7.605 -22.561 -16.405 -25.694 -11.651 5.427 14.806 -4.233
mean 120
sd 22

What's the table telling us? With this mean and standard deviation, we can predict the actual values reasonably well. (We can tweak the numbers and do even better.) It certainly doesn't prove this is the mechanism, but it isn't shown to be false.

I believe it is more complicated than that. Twin studies show that:
"genetic factors do not play a major role in causing typical PD. No genetic component is evident when the disease begins after age 50 years. However, genetic factors appear to be important when disease begins at or before age 50 years." [2]
More recent work puts more weight behind a genetic component. Do et al. write:
"Our heritability estimates, which suggest that genetic factors account for at least one-fourth of the total variation in liability to PD" [3].

But, I am suprised at how close such a simple model can get.

Ron's question is a reasonable one.

References

[1] "Critically Canadian: Canadian Critical Illness Standalone Base Incidence Tables"
Canadian Institute of Actuaries, July 2012.
http://www.actuaries.ca/members/publ...12/212059e.pdf

[2] "Parkinson Disease in Twins, An Etiologic Study"
Caroline M. Tanner, MD, PhD; Ruth Ottman, PhD; Samuel M. Goldman, MD, MPH; Jonas Ellenberg, PhD; Piu Chan, MD, PhD; Richard Mayeux, MSc, MD; J. William Langston, MD
JAMA. 1999;281(4):341-346. doi:10.1001/jama.281.4.341.
http://jama.jamanetwork.com/article....ticleid=188406

[3] "Web-Based Genome-Wide Association Study Identifies Two Novel Loci and a Substantial Genetic Component for Parkinson's Disease"
Chuong B. Do, Joyce Y. Tung, Elizabeth Dorfman, Amy K. Kiefer, Emily M. Drabant, Uta Francke, Joanna L. Mountain, Samuel M. Goldman, Caroline M. Tanner, J. William Langston, Anne Wojcicki, Nicholas Eriksson
PLoS Genet 7(6): e1002141. doi:10.1371/journal.pgen.1002141
http://www.plosgenetics.org/article/...l.pgen.1002141


John

I wonder if the fast onset of dyskenisia in young onset PD is from doctors starting them on large doses of sinemet instead of starting at a very low dose .They overwhelm the system...the body can react very quickly to this onslaught ...doctors should become more informed about the drugs and start with minimal doses. They started out with such heavy doses on my brother and then had to keep adding other drugs to counteract what I feel was an already overdosed state ....he lasted only a few years
I do feel that natural l-dopa added to the diet and good nutrition would play a big role in elderly people with signs of the disease. My brother would come to visit dad and I in Florida several years ago for a month. After about a week of diet change , sunshine and exercise ...his symptoms would improve so much that it was hard to believe. Then he would go home to Ohio and back to white store bread, lunch meats, no green vegies or beans and lots of sweets. He immediately was back where he'd started physically.
This spoke volumes to me .

Aunt Bean,

You write:
"My brother would come to visit dad and I in Florida several years ago for a month. After about a week of diet change , sunshine and exercise ...his symptoms would improve so much that it was hard to believe. Then he would go home to Ohio and back to white store bread, lunch meats, no green vegies or beans and lots of sweets. He immediately was back where he'd started physically."

Did he recognize the difference?

If so, why did he go back to his old ways?

John

Ron, post #1, writes:

A recent paper gives some evidence for this:

"Parkinson’s drug helps older people to make decisions Friday, March 29, 2013

London: A drug [levodopa] widely used to treat Parkinson’s disease can help to reverse age-related impairments indecision [sic, should be "in decision"]making in some older people, a study from researchers at the Wellcome Trust Centre for Neuroimaging has shown."

http://www.aalatimes.com/2013/03/29/...ake-decisions/

John

[QUOTE=johnt;973703]Ron, post #1, writes:



A recent paper gives some evidence for this:

"Parkinson’s drug helps older people to make decisions Friday, March 29, 2013

London: A drug [levodopa] widely used to treat Parkinson’s disease can help to reverse age-related impairments indecision [sic, should be "in decision"]making in some older people, a study from researchers at the Wellcome Trust Centre for Neuroimaging has shown."

http://www.aalatimes.com/2013/03/29/...ake-decisions/

This to me is scary. Are they going to suggest all seniors take sinemet? What if someone doesn't want to? What senior would not want to take sinemet if they thought they would be smarter, remember better, etc.? Sheesh.

Also, I find it almost incredulous that after decades of levodopa use, and the ever-increasing "finding" of dementia in PD (which contradicts my research*) that now, suddenly, scientists discover that seniors, the largest demographic group (aka: source of money for daily Rx) benefit from levodopa....what? I hope I'm not the only one that sees the problem here.

*according to my readings, cognitive issues were not listed as part of PD until the 1960s (and in fact what I read said cognitive decline did NOT occur in PD)....when did sinemet come out again?

lurking,
your statement "*according to my readings, cognitive issues were not listed as part of PD until the 1960s (and in fact what I read said cognitive decline did NOT occur in PD)....when did sinemet come out again? "

imho is poorly researched and possibly incorrect. last time you posted this i thought i posted a link to an article that refuted your statement. i sure suffered cognitive decline before taking any drugs and most pd'ers nowadays start off on agonists, not sinemet. sinemet seems to relieve my brain fog.

as far as pd etiology, seems with the advent of earlier and earlier detection via new biomarker and cheaper lab analyses, pd will be detected early enough to find true correlations rather than detecting it 20-30 years after the causative events occurred.

that's where i see the most research efforts going, earlier detection and getting those people into clinical trials to test neuroprotective drugs.

...by convincing everyone that your tests came back marked "Future Vegetable" but thank goodness Big Pharma is standing by with a new wonder drug (translate new patent) cleverly developed from their old drug (translate out of patent).

John T....my brother passed in December without ever trying my natural l-dopa or changing his diet. He stuck to his old diet to the end .....even though he knew his diet had alot of influence on his symptoms. We had all the same symptoms. Before we went to Ohio to see him the last time I had very hard physical exertion all day and was staying up late to put up beans. My shoulder began to writhe in sympathy with my pain I guess while I was finishing up before finally going to bed. When we were with Larry , he was having pain and his one shoulder started writhing....all I could think off was that it was just one more thing we shared in common (but I took tincture and mine went away) We also shared phantom arm on the same side. Diet and non-chemical treatments are all that I will do. So far I am doing well , even though I know my symptoms have progressed over the last four years...they are still controlled, just have to take more tincture than I used to. Plus homemade fermented papaya , diet and exercise, sunshine too. ..will far pass any drugs man can come up with. God is good Have a blessed day