Objective: To examine the influence of age of onset on the non-motor symptom (NMS) burden among individuals with Parkinson’s disease (PD) in Singapore.

Background: Non-motor symptoms are now recognised as major contributors to reduced quality of life in PD. However, the relationship between age of onset and specific non-motor symptom domains remains insufficiently characterised, particularly in Asian populations.

Method: In this cross-sectional study, 423 PD patients were recruited from a tertiary hospital movement disorders clinic between 2010 and 2015. Motor symptoms were assessed using the Unified Parkinson’s Disease Rating Scale (UPDRS) and non-motor symptoms using the Non-Motor Symptoms Scale (NMSS). Sociodemographic data were collected. Multiple linear regression with backward elimination was performed; NMSS scores were log-transformed due to skewness. Analyses were conducted using Jamovi 2.7.

Results: The regression model was statistically significant (F(4,423) = 28.2, p < 0.001), explaining 16.9% of the variance (R² = 0.169). Higher UPDRS total scores (B = 0.009, p < 0.001), longer disease duration (B = 0.043, p < 0.001), female gender (B = 0.214, p = 0.018), and older age of onset (B = 0.007, p = 0.001) were independently associated with greater NMS burden. Disease duration showed broad associations across all NMSS domains (all p < 0.05), whereas age of onset demonstrated domain-specific effects, significantly influencing five domains: Attention/Memory (p = 0.009), Gastrointestinal (p = 0.003), Urinary (p < 0.001), Sexual Function (p = 0.027), and Miscellaneous (p < 0.001). Employment status was associated only with the Miscellaneous domain.

Conclusion: Age of onset, disease duration, motor symptom severity, and gender are significant determinants of NMS burden in PD. Notably, age of onset exerts selective rather than global effects on NMS, with younger-onset patients showing greater vulnerability in cognitive and autonomic domains. These findings suggest distinct mechanisms underlying NMS heterogeneity and highlight the importance of targeted monitoring and personalised management—particularly for younger-onset patients, for whom cognitive and autonomic impairments can have substantial social, familial, and occupational consequences.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/age-of-onset-as-a-predictor-of-nonmotor-symptom-severity-in-parkinsons-disease/