Patient benefits of l-dopa and a decarboxylase inhibitor in the treatment of Parkinson's disease in elderly patients.

Sixty patients suffering from Parkinson's disease, irrespective of previous treatment, were recruited and treated with benserazide/l-dopa or carbidopa/l-dopa, randomly allocated, in a double-blind comparative study. Duration of disease on entry was 1 year or less in 70% of patients and was graded as moderate in 55% of patients. Mean age of patients on entry was 76 years for males and 80 years for females. Assessments were made before treatment and after 1 week, 3 weeks, 6 weeks and, finally, at 12 weeks. The dosage of drug was titrated at each visit to give minimum risk with acceptable benefit. Both drugs effectively improved the disability scores of the parkinsonian symptoms and the Sheffield Unit's Activities of Daily Living scores, the latter showing the immediate benefit for the patient in terms of independence. More patients improved in the benserazide/l-dopa-treated group. Furthermore, apart from one activity the improvement in each individual symptom and activity was greater in the benserazide/l-dopa-treated group, but none of the differences reached a statistically significant level. Adverse events recorded during the study were few and in many cases transient. Two patients defaulted (1 on each treatment) and 7 patients died during the study from non-drug-related causes.