Early Onset Parkinson's Disease - A Disease of Generativity

I was recently asked several times to provide some explanation about the difference between early and non-early onset Parkinson’s disease. This seems a fair question given that I am, at this moment, writing a blog about the former.

My standard answer is that early-onset PD is distinguished by the stage of life at which it occurs. Women and men with early-onset PD are typically still in the portion of their life the great developmental theorist, Eric Erikson, defined as one of generativity. The best way to define this concept is to think in terms of guiding the next generation. Generativity underlies our response to “how do I make my life count?”

Generativity is the process that guides not only our relationships with family and friends but also our impact on the broader world through our career and our contributions to the broader society. It is our expression of creativity and productivity that drives us to influence the generation that follows us. Parenting is but one possible facet of this process. We express our generativity by contributing in some way to the broader society. Erikson believed that failure to express our generativity as a result of our own self-centeredness or unwillingness to be productive in some manner resulted in a sense of stagnation.

There are a number of tasks typical of generativity. We nurture the development of the next generation and help launch them into life as independent men and women who will in turn begin their own period of generativity. We engender and provide for our families, engage in their individual lives, guide them, mentor them, and provide them both a safe environment and opportunity for the future. During this period, we begin a role reversal with our aging parents who begin moving to a new phase of life marked by a decline in robust health and a less direct contribution to the world around them. Generativity marks the ascent as well as maturing of our careers, relationship with our mates, and creative use of our leisure time.

When PD strikes during our period of generativity, it becomes an unwelcome intrusion precisely because it brings on a feeling of stagnation. The developmental tasks that are so integral to our sense of whom and what we are become compromised by the presence of a neurological nemesis over. Early onset Parkinsons is an assault on generativity. In contrast, when PD strikes later in life, many of the generative tasks are near completion or finished. The symptoms of the disease are no less aggravating than they are for a younger person but they are not as prone to interfering with a developmental task so critical to one’s sense of legacy.

I have never been completely comfortable with the idea that early-onset PD is a distinct entity in the Parkinson’s spectrum. I think most of us would be comfortable defining this unwelcome visitor by the effect it has on the critical tasks we hope to accomplish in the stage of life that defines who we are and the gifts we hope to leave for future generations.


Dr. Paul

NOTE: Dr. Paul Short is neither an agent nor employee of ADPA or any of its affiliate organizations. The views expressed in this blog are the opinions of Dr. Short and do not represent the opinions or endorsement of APDA. The information contained on this site is for your general information only and is not intended as, or a substitution for, medical advice. You should also be aware that the information on this site may not reflect the most current medical developments, nor is it provided in the course of a physician - patient relationship. You should always consult your physician or other qualified healthcare provider or expert with any questions or concerns you may have regarding a health or medical condition. You should never disregard professional medical advice, or delay in seeking it, because of something you have read on this site.


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