Short Communications Open access

The key points for treatment of Parkinsonism in older persons

Authors

  • Fulvio Lauretani – articles in this journal Corresponding author Email Internal Medicine and Critical Subacute Care Unit, Laboratory of Disability Prevention, Department of Geriatrics and Rehabilitation, University-Hospital of Parma; Department of Clinical and Experimental Medicine, University of Parma, Italy.
  • Andrea Ticinesi – articles in this journal Internal Medicine and Critical Subacute Care Unit, Laboratory of Disability Prevention, Department of Geriatrics and Rehabilitation, University-Hospital of Parma; Department of Clinical and Experimental Medicine, University of Parma, Italy.
  • Tiziana Meschi – articles in this journal Internal Medicine and Critical Subacute Care Unit, Laboratory of Disability Prevention, Department of Geriatrics and Rehabilitation, University-Hospital of Parma; Department of Clinical and Experimental Medicine, University of Parma, Italy.
  • Marcello Maggio – articles in this journal Department of Clinical and Experimental Medicine, University of Parma; Department of Clinical Geriatrics and Geriatric Rehabilitation, University-Hospital of Parma, Italy.
Published
11 January 2017
Section
Short Communications
DOI
10.4081/gc.2016.6156

Abstract

Signs and symptoms of Parkinsonism have a high prevalence in older persons. Parkinsonism is associated with negative outcomes in the elderly and there is still uncertainty about when and how to start levodopa in these conditions. The diagnosis of idiopathic Parkinson disease is often not pursued in the oldest old. The coexistence of both motor and cognitive impairment is the strongest factor limiting the initiation of treatment with levodopa and/or dopamine agonists in a geriatric setting, given the possibility of producing psychotic symptoms, such as visual hallucinations. It seems reasonable to perform at least one attempt to administer levodopa in older persons with parkinsonism, especially when symptoms and motility disorders are evident, in order to try to obtain an improvement in walking speed and balance. Important signs that should guide treatment for Parkinsonism in older persons are the presence of line-pipe rigidity and cogwheel rigidity.

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