Management for motor and non-motor complications in late Parkinson's disease

Geriatrics. 2008 May;63(5):22-7.

Abstract

The prevalence of neurodegenerative diseases such as Parkinson's disease (PD) increases with age. In an aging population, an understanding of the management of late complications of PD is becoming ever more important. Drug treatment for Parkinson's disease is largely symptomatic and relies primarily on levodopa (L-dopa) and adjuvant therapies including dopamine agonists and catechol-O-methyltransferase (COMT) inhibitors. Rehabilitation and allied health input also constitutes a core part of successful management. Most subjects who are symptomatic for more than 5 years are prone to late complications of PD. Some of these are related to the treatment, such as motor fluctuations, including the "on-off" phenomenon and levodopa-related peak dose dyskinesia. Others, such as postural hypotension, falls, psychosis, and dementia, although well-recognized problems in the elderly, often require different treatment strategies if occurring in the context of PD. The practical evidence-based management of motor and non-motor complications in late PD is discussed.

Publication types

  • Review

MeSH terms

  • Accidental Falls / statistics & numerical data
  • Aged
  • Antiparkinson Agents / therapeutic use
  • Comorbidity
  • Dementia / epidemiology
  • Dyskinesias / etiology
  • Humans
  • Hypotension, Orthostatic / epidemiology
  • Levodopa / therapeutic use
  • Parkinson Disease / complications*
  • Parkinson Disease / drug therapy
  • Parkinson Disease / epidemiology
  • Parkinson Disease / rehabilitation
  • Parkinson Disease / therapy*
  • Sleep Wake Disorders / epidemiology

Substances

  • Antiparkinson Agents
  • Levodopa