Premium
Pharmacological management of Parkinson’s disease in older people
Author(s) -
Mouchaileh Nadia,
Hughes Andrew J.
Publication year - 2020
Publication title -
journal of pharmacy practice and research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.222
H-Index - 22
eISSN - 2055-2335
pISSN - 1445-937X
DOI - 10.1002/jppr.1683
Subject(s) - medicine , amantadine , dyskinesia , polypharmacy , motor symptoms , levodopa , disease , parkinson's disease , dementia , ropinirole , adverse effect , physical medicine and rehabilitation , psychiatry , intensive care medicine , pharmacology
Abstract Parkinson’s disease is a chronic neurodegenerative disorder that mainly affects older people. It is predominately recognised as a movement disorder; however, the non‐motor symptoms are gaining increased recognition. Treating both motor and non‐motor symptoms can be challenging. Co‐morbidities, in particular dementia, polypharmacy and an increased susceptibility to adverse medication effects often necessitate a different approach to management compared to younger patients. In older people, the mainstay of treatment for motor symptoms is levodopa. However, long‐term side‐effects including motor fluctuations and dyskinesia can be severely disabling and may require the addition of adjunctive agents including dopamine agonists, catechol‐o‐methyltransferase inhibitors, monoamine oxidase‐B inhibitors and amantadine. Medications can significantly improve symptoms; however, optimal management of motor and non‐motor symptoms usually requires a multidisciplinary approach. In this article we present an evidence‐based review of Parkinson’s disease treatments and guidance to improve clinical management and outcomes in older people.