Parkinson’s disease is a complex, progressive neurological condition with growing prevalence and significance for the insurance industry. As the fastest growing neurological disorder worldwide, its impact extends beyond clinical care – raising important considerations for underwriting, claims assessment and product development.
In this article, we delve into the intricacies of this condition, aiming to enhance understanding of its pathophysiology, clinical manifestations and management strategies. By highlighting the latest advances in research and treatment options, we aim to equip clients with the knowledge needed to make confident, well-informed decisions in an evolving risk landscape.
Parkinson’s disease results from the gradual loss of dopamine-producing neurons in a region of the brain called the substantia nigra. Dopamine is a key neurotransmitter involved in coordinating smooth, purposeful movement. Although the disease is commonly recognized as loss of motor control, the effect of low dopamine can impact senses, cognition and mental health.
As the fastest growing neurological disorder worldwide, its impact extends beyond clinical care.”
The exact cause of Parkinson’s remains unknown, however, in some cases it can be inherited [1]. While it is more common in people over age 60, young-onset Parkinson’s disease can occur in adults as young as 20 [2].
Since Parkinson’s disease effects the central nervous system, there are symptoms that can be either chronic or progressive. In most cases, symptoms have progressed by the time a diagnosis is made, and people have difficulty with movement control including tremors, stiffness and impaired balance [3]. Common motor symptoms include:
Though motor symptoms can make completing even the simplest task challenging, other non-motor symptoms can significantly impact the quality of life:
While Parkinson’s disease itself may not significantly reduce life expectancy, symptom-related complications – such as aspiration pneumonia or falls – can contribute to serious health risks.
The disease can have a significant impact on a person’s daily life and functioning. The type, number, severity and progression of Parkinson’s disease symptoms vary greatly, with each person being affected differently. Some may not get every symptom, and changes can be experienced over 20 years or more [4].
Figure 1: Stages of Parkinson’s Disease, Source: https://parkinsonsdisease.net/basics/stages
Many early-stage Parkinson’s disease cases remain undiagnosed, which is a stage where interventions may be most effective and cost-efficient. The traditional approach, in which clinicians wait for patients with Parkinson’s disease symptoms to seek treatment, has limitations.
Parkinson’s disease is the fastest-growing neurological condition globally, with incidence rates doubling over the past 25 years.”
Conditions like REM sleep behavior disorder, with a predictive value exceeding 90% for Parkinson’s disease,[5] is increasingly recognized as a key prognostic indicator. Incorporating simple screening questions about dream enactment behaviors may significantly enhance early risk stratification and identification.
Early and proactive identification of Parkinson’s disease could enable timely interventions, and digital health technologies have the potential to support large-scale identification and early diagnosis.
Parkinson’s disease is the second most common neurodegenerative disorder after Alzheimer’s Disease, affecting over 1 million people in the U.S[6]., compared to over 30,000 with Amyotrophic Lateral Sclerosis (ALS)[7]. While Alzheimer’s Disease primarily impairs memory and language, which are functions associated with the frontal and temporal lobes, Parkinson’s disease is more centrally located, affecting the basal ganglia and substantia nigra, which are critical for motor control.
ALS, by contrast, is a motor neuron disease that targets peripheral nerves, leading to rapid and fatal muscle wasting, and is often considered the most devastating of neurodegenerative diseases.
Parkinson’s disease also shares some pathological overlap with Lewy Body Dementia, particularly in the presence of alpha-synuclein aggregates, and both conditions can present with motor and cognitive symptoms. However, Parkinson’s disease typically begins with motor dysfunction, e.g.; bradykinesia, rigidity, and tremor, while Lewy Body Dementia often presents with early cognitive decline.
Notably, Parkinson’s disease is the fastest-growing neurological condition globally, with incidence rates doubling over the past 25 years[8]. This growth underscores the urgent need for disease-modifying therapies and improved diagnostic tools.
There is no cure for Parkinson’s disease, and most available medications mostly focus on managing the symptoms. Current medications include:
Continuous research is being done to identify new treatments and therapies. Scientists are exploring genetic therapies, autophagy enhancement, and senolytics to target underlying disease mechanisms. Exercise and light therapy also show promise in improving symptoms and quality of life. Ongoing research into CRISPR gene editing and disease-modifying treatments offers hope for the future.
In early 2025, The US Food and Drug Administration (FDA) approved Onapgo, a new therapy for Parkinson’s disease. This therapy targets people with progressing Parkinson’s disease who experience significant motor control fluctuations throughout the day. This is a continuous, under-the-skin infusion that delivers apomorphine, a drug that helps control motor symptoms like tremors. It is the first infusion based apomorphine therapy approved in the US for Parkinson’s disease[9].
As Parkinson’s disease progresses, motor symptoms may become less responsive to medication, resulting in increased functional impairment. While several treatments remain effective in managing symptoms, many individuals also turn to complementary strategies for additional relief. Research suggests that maintaining a healthy diet and engaging in regular exercise can support muscle function and overall quality of life in individuals with the disease[10].
In a groundbreaking pilot study[11], researchers at the University of California, San Francisco (UCSF) safely administered psilocybin, a psychedelic compound found in “magic mushrooms” to patients with mild to moderate Parkinson’s disease. This marks the first time a psychedelic has been tested in a neurodegenerative disease population.
Participants received two doses (10 mg and 25 mg) spaced two weeks apart, alongside eight psychotherapy sessions. The results were striking — patients experienced clinically significant improvements in mood, cognition, and motor function that persisted for weeks after the drug had cleared their systems.
These findings are particularly compelling given that symptoms in Parkinson’s disease, such as depression and anxiety, often precede motor symptoms and are strong predictors of quality of life. Traditional antidepressants frequently fail in this population, suggesting that psilocybin may offer a novel therapeutic pathway. Encouraged by these results, UCSF is now launching a larger clinical trial to further explore psilocybin’s potential in Parkinson’s disease treatment.
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Figure 2: Case Study example of Parkinson’s disease in underwriting context.
Given the applicant’s age, disease progression, and current functional status, this case would be accepted as substandard for a whole of life product. A moderate mortality loading would be applied to the premium.
Parkinson’s disease is considered the fastest-growing neurological condition worldwide[12]. Its progressive nature means symptoms often intensify over time, with severe cases posing greater challenges for care and financial risk. By understanding the disease’s stages, treatment options, and wide variability between individuals, risk experts can better anticipate potential outcomes and make informed underwriting decisions. Ongoing vigilance, continual education, and adaptation of underwriting practices are essential as research advances, and the global burden of Parkinson’s disease continues to rise.
Please contact us if you would like to find out more about developments in Parkinson’s disease and/or to discuss the mortality and morbidity impacts. We would be happy to set up a meeting with you.
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Cillian Tierney, Head of Medical Underwriting Propositions and Products, Global Life & Health
[1] https://my.clevelandclinic.org/health/diseases/8525-parkinsons-disease-an-overview
[2] https://my.clevelandclinic.org/health/diseases/8525-parkinsons-disease-an-overview
[3] https://www.ninds.nih.gov/current-research/focus-disorders/parkinsons-disease-research/parkinsons-disease-challenges-progress-and-promise
[4] https://www.parkinson.org/understanding-parkinsons/what-is-parkinsons/stages
[5] https://pubmed.ncbi.nlm.nih.gov/11481685/
[6] https://www.parkinson.org/understanding-parkinsons/statistics
[7] https://www.cdc.gov/als/php/abstracts-publications-reports/prevalence-2022-2030.html#:~:text=Summary,to%20ALS%20research%20and%20patients.
[8] https://pmc.ncbi.nlm.nih.gov/articles/PMC6311367/#:~:text=Neurological%20disorders%20are%20now%20the,has%20been%20a%20rare%20disorder.
[9] https://www.michaeljfox.org/news/second-under-skin-infusion-parkinsons-earns-fda-approval
[10] https://www.ninds.nih.gov/current-research/focus-disorders/parkinsons-disease-research/parkinsons-disease-challenges-progress-and-promise
[11] https://www.nature.com/articles/s41386-025-02097-0
[12] https://pmc.ncbi.nlm.nih.gov/articles/PMC6311367/#:~:text=Neurological%20disorders%20are%20now%20the,has%20been%20a%20rare%20disorder.