[Ronhutton]

Could PD simply be the onset of early old age??
I asked myself this question some months ago, when I saw Mrs Thatcher trying to walk. It was me exactly when unmedicated. Then today I read pensioners tend to lose their sense of smell at age 65, before they become incapacitated,. just like PD sufferers. I then saw a report which stated exercise turns back the clock for pensioners, juzst like PD. So could levodpa extend the higher quality of life for pensioners??
Anyone got a white rat granny??
Ron

[Conductor71]

Originally Posted by Ronhutton

Could PD simply be the onset of early old age??
I asked myself this question some months ago, when I saw Mrs Thatcher trying to walk. It was me exactly when unmedicated. Then today I read pensioners tend to lose their sense of smell at age 65, before they become incapacitated,. just like PD sufferers. I then saw a report which stated exercise turns back the clock for pensioners, juzst like PD. So could levodpa extend the higher quality of life for pensioners??
Anyone got a white rat granny??
Ron

Ron,

I am inclined to disagree. I don't have any hard stats but just think of how many older people you do encounter on a daily basis. Can you count ten elderly you encounter in any given week. If PD were simply a mechanism of aging, then statistically would we not see a heck of a lot more stooped people with a shaking claw? Further if you see someone who has the signs of Parkinson's and that is simply old age than what does that mean about dopamine loss? According to the pundits, we show motor symptoms at 70-80% loss of our dopaminergic neurons. This too would have to apply to your pensioner. Why would he lose 70-80% pf his neurons, but ten of his mates walk upright with a normal stride and no tremor? Or are we saying that the other older folks who show no symptoms still have PD; it just hasn't become apparent yet? Also, statistically it hits when we are older, so perhaps because we see more older people because it is more prevalent ages 60 and up?

This is one of those things that doctors purportedly tell us; one of the many platitudes is that "We'd all get PD, if we lived long enough." To that I say "baloney". Statistics show; in fact; that the longer one lives the "least likely" they are to acquire PD. Oldest of people in 90's and over do not get it. I think there is indeed a window of likelihood that starts in 80's-89...I'll try and find a reference. I honestly don't even think that young onset PD and the later stuff are even the same thing. Why is there such a long latency in YO and a slower progression; with faster progression in older PD patients and that I know of not much of a prodromal period? I think what research has meant is that the neuronal loss imitates apoptosis or normal cell loss due to free radicals etc. that come with aging.

Finally almost always older onset PD can be correlated more with environmental factors. This is where we are all being harmed the most; there is such a profound lack or concern for epidemiological data it is truly PWP and Normals plus their families if concerned with recall and reliability. Further maybe those interviewed should all undergo DAT scans to compare brains of those equal in age and sex and perhaps lifestyle factors such as exercise, caffeine intake, smoking, etc. No one bothers because it is easier to compartmentalize PD into a disorder of old age.

The stats from The Cleveland Clinic:

Identifying an accurate number of patients with Parkinson's disease is difficult, especially in the early stages of the disease. Many people attribute the early symptoms to the "aging process" and do not seek help from their physicians. Diagnosis also poses certain difficulties because other conditions present similar symptoms. Therefore, some of those people diagnosed with Parkinson's disease may not have the disease and conversely, those diagnosed with other disorders may actually have Parkinson's disease. Research estimates that about 1,500,000 Americans have Parkinson's disease, with approximately 50,000 new cases diagnosed each year in this country.

Age seems to be the most clear correlation with the disease, at least in the onset of symptoms. Parkinson's disease, in general, affects those over age 50, with the average onset being at age 60. Recently, either due to early recognition of symptoms or earlier onset of the disease, physicians have reported more cases of Parkinson's under age 40. Some physicians estimate the incidence under age 40 to have risen to 5 to 10 percent over the past several years.

Laura

[Ronhutton]

Hi Laura,
Thanks for replying. Having a debate about these points unearths more than if you simply do a search. It takes you in directions you had not considered.
I agree that if the possibility was correct. then you would not see a lot more people showing PD symptoms. Everything would be the same as we see today. Incidence of PD is a logaristic curve with age, hence the "proverb", If we all lived long enough, we would all ultimately get PD").
All parts of our bodies decay with age, and if the BBB theory holds water, then those people who started life with a more leaky membrane will simply show PD symptoms earlier. If your heart deteriorates before your BBB or whatever is the cause of PD, then you will die of a dodgy heart.
I was intending simply throwing in the question, but it seems the concept is more widely researched than I realised. I was more interested in seeing whether levodopa would extend the useful active life of a pensioner.
Assuming the possibility of old age being a form of PD, the pensioner is living out the last of his time in an "off" state. My thoughts were could he be raised to an "On" state with levodopa? He would not need to worry about developing dyskinesia, since he would probably have died before long term side effects arose. At least he would have pleasenter final years. A simple search got over 100,000 hits on Aging & Sinemet, so will do some digging.
Ron

[reverett123]

Lord knows I don't want to be difficult, but a great deal depends on whether or not PD is really a single disease or half-a-dozen. There is also some question as to what wemean by "aging". Is it decline in mitochondrial function? Teleomere (sp?) length? Is the 40-yo PWP with raging microglia pumping out cytokines in a different place than an eighty year old who has trouble with buttons? Of course he is. Maybe it isn't "true" aging, but the result seems the same.

Pubmed turns up 65 for "parkinson's" + "accelerated" + "aging"

[Conductor71]

Ron,

I am truly sorry. None of that was directed at you; it's just a wee bit of anger that I should channel into something constructive. I guess for me when I see PD equated with accelerated aging, it raises my ire because it is laden with so much more: Equating PD as a disease of old age:

-feeds into stereotype that many in States have; that it is only reserved for those in a nursing home.
-society generally cares very little for older people.
-levodopa can be therapeutic minus the dyskinesia, but I think the no dyskinesia in older onset cases is due to something else not the shorter term use of drug. Some young onset people become dyskinetic in a year even some it just takes months. Honestly, I think they are two different things.
-the fact that levodopa may be used for a shorter time in majority...well all of this, I think, perpetuates myth that PD is pretty darn benign for a neuro disease and it hold back research innovation in improved treatment.

Anyway, apologies Ron.

Oh,and I am thinking that older folks you see have undiagnosed PD or opt to delay or fore go treatment. According to the Cleveland Clinic site the misconception that shaking, stooped posture, and slow shuffling walk is a natural part of aging results in inaccurate counts on actual PWP. I have also read that PD isn't so rare in African-American community...again they have no idea their symptoms are abnormal.

So your guy could probably benefit from levodopa!

Laura

[lindylanka]

I met an 81-year old lady at my bus stand a few week ago, going home with her shopping in the rain, as I was. Similar size to me (large), and she had a shaky right hand. BUT she had a long stride, could get out of her seat in one, and had a huge smile. This was despite the fact that she had surgery on tendons in both feet barely three weeks before. She was more mobile than I was ten years ago! I see quite a lot of people like that. Healthy and old. If they are ailing it is because they have health problems. Not because they are old. It is a myth that old age itself is like a disease. There are marathon runners in their eighties, and people who cycle across countries and continents in later life. Accepting that old age is like a disease is like abdicating responsibility for helping older people maintain health, and if they buy into that myth then they stop hoping for an active old age and settle for the very things that accelerate aging....They come in all shapes and sizes too, they are just fundamentally active, mentally and physically....

[Ronhutton]

Laura,,
Don't worry, I didn't take any offence from your post. You gave a good well thought out response which I was grateful for
Lindy, Does the fact that you met an 81 year old in good health and long stride really prove that old people in poor health with a short stride are not suffering from PD. If the idea was correct, you would expect exactly that. Old people at the top end of the graph, (but fewer of them) who run marathons etc They are the lucky ones.
I would envisage a set of data such as the table below if there was any truth in the suggestion. Just made up figures to show what I mean.

Age range I 30 - 40 I 40 - 50 I %0 - 60 I 60 - 70 I 70 - 80 I 80 - 90 I >90
% PD I 2% I 3% I 4% I 15% I 24% I 45% I 60%
Please don't take me to task on the figures, I made them up. but Lindy's 81 year old would be one of the 55% of healthy ones in age 80 - 90.
Mrs Thather, in the same age range, is. like us, one of the unlucky ones.
This was only an observation, that there are great similarities between PD and aging, it looks like the same process. But I can well understand the reluctance of PWP to accept that PD could mean premature aging.
. Ron

[Conductor71]

Originally Posted by Ronhutton

This was only an observation, that there are great similarities between PD and aging, it looks like the same process. But I can well understand the reluctance of PWP to accept that PD could mean premature aging.
. Ron

I think this is the part I don't understand and perhaps this reflects our personal experiences, where we have grown up, etc. In my little corner of the universe even seeing an aged person with stooped posture, shuffling gait or shallow stride, or tremor...to me any of those things would look abnormal. In my mind aging has meant slowing down, more of a gingerly walk and a dowager's hump. I guess for me the only corollary I see outwardly then is slowed movement, oh and I will say, that most older people I have known do have that same spidery early PD handwriting change. I recall visiting my grandma when she moved into a senior's apt. and to look at the notes posted on the bulletin board by various residents, you'd think it was all by the same person.

In addition to our personal experiences, what else may sway us to think that normal aging and PD appear the same? I'd say that the classic drawing that accompanies The Shaking Palsy essay does a lot to our collective mind's eye when we envision old age. Anyway, this would make for an interesting psycho-social study by any means...

Laura

[lindylanka]

I think that I was not saying that... I was simply challenging, intellectually only of course, , the notion of aging and illness being the same thing. Which is what you also are saying Ron!

Once alzheimers was seen as being part of aging, and rheumatism, which is of course no longer called that by any other than lay people, because it is a generic term for many conditions. When you take all of these so-called signs of old age away, because they are actually signs of disease, what you are left with is some mainly quite healthy people who are pretty old. And 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.

In some parts of the world many who get to old age are like this, life has weeded out a lot of people on the way. Through infectious disease, and diseases of affluence. The medical model of old age is not the only one.

There are a lot of older people out there right now who are not doing things because their expectations of themselves are that old age is only about certain decline. On the other hand there are a lot of people who are very active, who are in all sorts of things, including taking one major roles in the bringing up of their grandchildren, becoming secondary parents almost, and parenting of any kind, substitute or not is hard work.

If we were to accept that PD and Alzheimers were a natural part of aging, then what explains the sisters who lead near identical lives, live in the same place, so similar physically, one gets a degenerative disorder and the other doesn't. One is healthy and has an energy that young people would envy, the other has a degenerative condition and is clearly ill. And yes, she looks considerably older than her healthy sister. She also looks as though she is very unwell.

Does the aging come first heralding the illness?
Or the other way round, the illness causes the 'premature' aging?

Premature aging is not how I would describe PD, surely it is premature degeneration through disease. What PD takes away is much more than aging..... Even very old people can still smile, communicate, move...

It's not that I don't accept the idea that we are prematurely agin, I do not believe that is what PD is......

Lindy

[Bob Dawson]

My hair started turning white when I was 27, and it still always seems that I was too early old, too late smart.