Impact of functional age on the use of dopamine agonists in patients with Parkinson disease.

BACKGROUND: Parkinson disease (PD) is primarily a neurodegenerative disorder that affects as many as 1,500,000 people in the United States. It is predominantly a disease of the elderly, and special treatment challenges must be addressed in this patient population. REVIEW SUMMARY: It has been generally accepted that PD patients over the age of 70 will have a shorter lifespan than younger patients and are at less risk for developing treatment-emergent complications by virtue of their lower exposure to medication over the course of the disease. Consequently, elderly patients are often treated aggressively when motor symptoms start to become disabling. Recent statistics, however, suggest that effective treatments for PD have helped to increase the longevity of PD patients, suggesting that elderly patients may, in fact, have sufficient medication exposure to raise concern over levodopa-induced motor complications. If this is the case, physicians should consider treating their elderly PD patients with dopamine agonists, which have several advantages over levodopa therapy, not the least of which is a lower prevalence of motor complications. CONCLUSION: Dopamine agonists are safe and effective in elderly patients and offer numerous advantages when used as either monotherapy or adjunctive therapy, particularly in patients requiring long-term treatment.