What Is Parkinson’s Disease?

Who is at risk?

About 90,000 U.S. adults 65 and older are diagnosed with Parkinson’s each year, according to a 2022 report in NPJ Parkinson’s Disease. Risk increases with age. Most people with Parkinson’s disease begin to notice symptoms around age 60, like Baker did.

As for what triggers the damaging brain changes that lead to the disease, gender and genes play a role; men are more likely to be diagnosed with the disease than women, and people with a sibling or parent with Parkinson’s, like Baker, have double the risk. However, Parkinson’s risk is still low, 2 to 4 percent for those with a family history and 1 to 2 percent for the general population.

Environmental factors are important too. Exposure to various pesticides and other chemicals and pollutants can raise risk, as does a history of repetitive brain injury.

For some people, the disease comes on at a younger age. At least 1 in 25 people who get Parkinson’s are younger than 50, according to the National Institute on Aging. Randy Devitt first noticed at 49 that his left hand could no longer keep up with his right when he tried to play “Linus and Lucy,” the Charlie Brown jazz classic, on the piano. An avid soccer player, he had been taking frequent spills on the field around that time, too. And when he walked, his arms didn’t swing. They hung stiff at his sides.

The disease tends to progress more slowly in people who get this early diagnosis. It also less often leads to memory and thinking changes important enough to affect daily life, a relatively common complication of later-onset Parkinson’s.

But getting Parkinson’s in middle age brings other challenges. “I was scared I was going to lose my job. That’s why I kept it ... close to my chest,” says Devitt, a firefighter when he was diagnosed. Firefighters may face higher risk for Parkinson’s, which may be due to exposure to hazardous chemicals and toxins, according to a 2022 study in the Journal of Basic and Clinical Pharmacy.

Devitt recalls various heavy chemical exposures throughout his life. He was exposed to industrial solvents as a firefighter, and even earlier, at his family’s service station, where he worked from age 13 through college.

In high school and college, Devitt was knocked unconscious multiple times playing soccer or football. “This was many years ago before the world started taking blows to the head more seriously,” he says. “It was called ‘getting your bell rung’ when it should have been labeled ‘repeated and cumulative brain damage as a result of violent trauma to the skull and brain.’”

Devitt plays modified, Parkinson’s-friendly “walking soccer” now.

How is Parkinson’s disease treated?

Medications. The main medications for Parkinson’s, such as combination carbidopa and levodopa, work by replacing the dopamine that’s lost when neurons important for movement die. These drugs can lessen movement symptoms.

The medications “do a pretty good job of controlling [movement] symptoms,” says Gilbert. If symptoms get worse, the doctor might increase the dose, change the medication or add something.

But whatever medications you take, Gilbert stresses, “They do not stop disease progression. They are only symptom modifiers.” Current research aims to find drugs that could slow or stop the progress of the disease.

Deep brain stimulation. Some people get good symptom control from medicine for several years, but eventually, as the disease progresses, the drugs may offer less benefit or complications may arise. ome of those people, including Devitt, may be good candidates for a surgical treatment called deep brain stimulation. He says he plans to have DBS at some point in the next year. In this procedure, a surgeon implants an electrode, or wire, deep into the brain to stimulate the area causing symptoms. It’s been described as a pacemaker for the brain, as it stays in place to offer regular stimulation of key brain areas and ease momvement symptoms. A reecnt advance in DBS offers an “adaptive” or “self-regulating” system that can monitor a person’s brain signals and symptoms and in response, adjust stimulation in real time.

Deep brain stimulation isn’t for everyone. It doesn’t work as well for balance or gait issues as it does for stiffness, slowness and tremor, Gilbert says. And it’s not recommended for people with significant memory or thinking changes, known as dementia. But for patients who meet certain criteria, deep brain stimulation may relieve tremor, stiffness and slow movements. And because people who have DBS can often decrease their dose of oral medications, the involuntary movements that can sometimes be side effects of these meds may diminish as well. Several randomized controlled trials have shown that DBS is better than standard medication in people who are eligible for it, according to a review published in 2025 in Australian Prescriber. 

Focused ultrasound. Another surgical procedure, called focused ultrasound, may be an option for some, too. This procedure uses ultrasound waves to alter areas of the brain that cause movement symptoms. It’s currently available for use only on one side of the brain, which means it helps symptoms on only one side of the body. While focused ultrasound does not require implanted wires, stimulation or programming, it is permanent and irreversible.

The key role of exercise for symptom relief

Because Parkinson’s symptoms can start out minor and Parkinson's medications, like all medications, come with potential side effects, not everyone takes medicine right away.

“We balance how much a person needs the medicine with [the risk of] side effects,” Gilbert says.

At first, a person may focus on lifestyle changes to help manage symptoms. A growing body of research suggests that exercise can ease symptoms, improve quality of life and potentially slow disease progression. Doctors recommend that everyone with Parkinson's exercise as part of their treatment plan.

“Exercise is one of the most powerful ways to change someone’s course with Parkinson’s,” Fleisher says. “Even if you are a never-exerciser, that’s OK. Start today.”

Baker says she started intensive workouts as soon as she learned she had the condition. Now, 11 years later, in addition to carbidopa-levodopa and amantadine every day, Baker still exercises consistently. The same goes for Devitt. 

“Newly diagnosed people often curtail their activity because they’re just traumatized,” Devitt says. “I’m lucky I’ve always enjoyed working out. For my money, exercise is absolutely the best thing you can do for Parkinson’s disease.” After 18 years with the disorder, he still plays soccer and water-skis.

What can you expect with Parkinson's?

Your doctor may not be able to give you a clear answer about your future with Parkinson’s. That's because everyone has a unique experience.

“If you’ve met one person with Parkinson’s, you’ve met one person with Parkinson’s,” Fleisher says. Some people who have Parkinson’s do well for 30 years. But, she says, those with a more quickly progressing form of the disease might be disabled in less than 10 years.

Though it does progress over time and it can slightly lower life expectancy, Parkinson’s itself is not considered fatal. But two common complications of the disease — falls and pneumonia — can be. Falls are the leading cause of injury-related death in U.S. adults over 65, according to the Centers for Disease Control and Prevention. The balance problems that can come with Parkinson’s make falls more likely. The pneumonia risk comes from difficulty swallowing, a common problem in progressing Parkinson’s disease. Food or saliva going down the wrong pipe can cause an infection.

Your doctor along with physical, occupational, speech and mental health therapists can help you manage and work around them. These are all supports worth asking about, though few people with Parkinson's disease who are Medicare beneficiaries use these services or meet with a movement disorder specialist, a neurologist with expertise in Parkinson's and other disorders that affect movement, according to a 2023 report in npj Parkinson's Disease.

Devitt calls himself a living example of the possibilities of living a full life after a diagnosis. “Most people newly diagnosed, all they can think about is the end, crippled up in a wheelchair.... But there’s an amazing amount of life between now and then — if that ever happens.” His advice: “Keep moving, keep walking, keep exercising, keep socializing. I keep talking, I keep singing to keep my voice strong. I take control of everything I can.... You’ve got a lot of life to live despite your illness.”

Editor’s note: This story, first published Feb. 13, 2024, has been updated to include new information.