Kimpara Teiko, Takeda Atsushi
Department of Neurology, National Hospital Organization Sendai Nishitaga Hospital.
Brain Nerve. 2020 Dec;72(12):1345-1352. doi: 10.11477/mf.1416201691.
The prevalence of Parkinson's disease (PD) has increased globally, especially in older age groups. Older age at onset is associated with more severe motor and nonmotor symptoms at diagnosis and more rapid and severe progression. Because majority of older people have multiple comorbidities, patients with PD may be misdiagnosed. Limited response to L-dopa medication in the older patients has been indicated. The risk of motor complications decreases with increasing age, while the risk of axial complications, hallucinations, and dementia increases. Evidence for many of the currently used PD medications is based on clinical trials with the criteria that exclude older patients, and it will be necessary to establish evidence of medication for PD in older patients.
帕金森病(PD)的患病率在全球范围内呈上升趋势,尤其是在老年人群体中。发病年龄较大与诊断时更严重的运动和非运动症状以及更快、更严重的病情进展相关。由于大多数老年人患有多种合并症,帕金森病患者可能会被误诊。已有研究表明老年患者对左旋多巴药物的反应有限。运动并发症的风险随着年龄的增长而降低,而轴性并发症、幻觉和痴呆的风险则增加。目前许多用于治疗帕金森病的药物的证据是基于排除老年患者的临床试验标准得出的,因此有必要建立老年帕金森病患者用药的证据。