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Hi Jennifer,

>what is the problem with
>the medical community that they seem to completely overlook PD as a
>possibility, especially in younger patients?

In our research (report to be launched 9th February 1999) we identified a
great ignorance of PD, its symptoms, and its effects, among all health
professionals, whether specialist neurologists, general practitioners,
pharmacists, dentists, nurses, physiotherapists, etc., etc.

Perhaps the main reason for this may be identified from a study commissioned
by the Australian Government from the Australian Science and Technology
Council.

The report, entitled "Management of neuro-degenerative disorders in older
people 2010", says in part, "The study found that there is grossly
inadequate education and training in the areas of gerontology and aging in
university medical schools.  This has resulted in medical practitioners
having poor skills for the management of NDDs (neuro-degenerative disorders)
in older people".

So true, but notice that even the writers of this report fell into the trap
of identifying NDDs, which include Parkinson's Disease, as being only
disorders of OLDER people! I might point out here that the term "older
people" in medical research-speak usually means those aged 70 and over!
(Perhaps because many researchers are themselves aged 60-70?  <grin> )

The eventual diagnosis of my own condition was complicated by the fact that
I had had a bad motor accident shortly before I began noticing symptoms of
PD.
I was pursuing an insurance claim, which, before it was settled, resulted in
me being referred by one side or the other in the claim to TWENTY-SEVEN
different doctors, NONE of whom suspected, or even hinted at PD.

Most seemed to favour a psychological or psychiatric disorder. As for that,
a paper by Lang AE et al, (Department of Medicine (Neurology), University of
Toronto, Ontario, Arch. Neurol. 1995 Aug;52(8):802-10, states that
Parkinson-like symptomology resulting from a primary psychiatric disorder is
a very rare event, if seen at all.  Much more common is psychiatric disorder
symptomology  masking underlying PD.

I was 44 at the time, and I think that this is a large part of the problem -
most health professionals taught before, say, 1990 (and many -most?- since),
were taught, in the wording of a popular medical text, that Parkinson's is "
a  disease of the sixth decade", in other words, of people 60 and over.

Yet there is much recent evidence, scientifically researched and published
in major journals such as the "New England Journal of Medicine", stating
that onset before the age of 30 is decidedly rare, but thereafter, both
incidence and prevalence of PD rise with increasing age.

Within any given studied population, as many as 10% of patients admit to an
onset before the age of 40, and a further 20% develop symptoms of the
disease before the age of 50. The mean age of onset is still in the mid-50s,
with approximately 40% developing the disease between the ages of 50 and 60,
whilst the remaining 30% experience onset over the age of 60.

In other words, the popular view is the opposite of the truth!

It will not be until doctors and para-medical health professionals are
educated to the fact that PD is common under 50, that this situation will
change.

Part of our ongoing commitment to our project will see kits produced for a
number of health specialities, explaining the complexities of PD treatment
and management, and pointing out that young-onset PD is an increasing
incidence.

Jim

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