Postural Instability in Parkinson’s Disease: Why Age Matters More Than Disease Duration

Falls and balance problems are among the most concerning symptoms for people living with Parkinson’s disease (PD). Postural instability—the loss of balance and difficulty maintaining an upright position—can significantly affect independence, confidence, and quality of life. Understanding when and why this symptom develops is critical for prevention and care planning.
​
Recent research is shifting how clinicians and individuals think about balance changes in Parkinson’s disease—and the findings may surprise you. Keep reading to learn more about this important study.

Here’s what makes this research especially important…
Postural instability may not depend on how long someone has lived with Parkinson’s, but rather how old they were when symptoms began. This insight opens the door to earlier intervention, better fall-prevention strategies, and more personalized care.

What the Study Found
A 2022 study titled “Onset of Postural Instability in Parkinson’s Disease Depends on Age rather than Disease Duration” examined 106 individuals with sporadic Parkinson’s disease. Researchers followed patients over time to determine whether balance problems were linked more closely to disease duration or age at onset.
The results were clear:

• Individuals diagnosed before age 50 developed postural instability much later--a median of 18.4 years
• Those diagnosed between ages 50–70 developed instability after about 14.2 years
• Individuals diagnosed after age 70 experienced postural instability far sooner--within a median of 5.7 years

Importantly, the severity of motor symptoms did not predict when postural instability would begin. Instead, age was the strongest determining factor.

Why Age Matters in Parkinson’s ProgressionThe study reinforces what earlier research has suggested: Parkinson’s disease tends to progress more rapidly when symptoms begin later in life. Even in people with tremor-dominant PD—often considered a slower-progressing subtype—age at onset still correlated with earlier balance difficulties.
Researchers also noted that treatments like deep brain stimulation had only a limited effect on postural instability, emphasizing the need for non-pharmacological strategies such as exercise and movement therapy.
The Role of Exercise in Managing BalanceExercise plays a crucial role in managing Parkinson’s disease and reducing fall risk. The Parkinson’s Association of Southwest Florida (PASWFL) offers in-person and online movement classes designed specifically for individuals with PD.
Exercise benefits include:

• Improved balance and mobility
• Increased muscle strength
• Better cardiovascular health
• Enhanced mood and reduced depression
• Support for cognitive function
• Social connection and reduced isolation
• Complementing medication effectiveness
• Potential neuroprotective effects

Individuals should always consult their healthcare provider or a physical therapist to create a safe, personalized exercise plan.
👉 Learn more about PASWFL movement classes:
https://parkinsonassociationswfl.org/education-programs.html

Why Support Matters
A diagnosis of any form of Parkinson’s can feel overwhelming. But with the right support and resources, individuals can maintain independence, quality of life, and emotional well-being.
For resources, referrals, and support, contact the Parkinson’s Association of Southwest Florida at www.paswfl.org or call 239-417-3465.

For over 25 years, PASWFL has provided free, high-quality services to individuals and families touched by Parkinson’s disease in Southwest Florida. Each week, PASWFL offers more than 25 free programs, including:

• Wellness and fitness classes
• Speech Exercise classes
• Educational seminars
• Support for care partners
• Support groups

There are no fees to become a member, and PASWFL welcomes anyone touched by PD.
Take the First Step Toward Living WellYou don’t have to face Parkinson’s alone.
👉 Sign up for the PASWFL newsletter: https://parkinsonassociationswfl.org/signup-enews.html
👉 Become a member—free and confidential: https://parkinsonassociationswfl.org/signup.html
To learn more, visit www.paswfl.org and discover the power of support, education, and community.