2022 年 39 巻 2 号 p. 51-57
In spite of the large number of elderly patients with Parkinson disease (PD) in Japan, there have been insufficient studies to provide useful information for their clinical management. In recent years, various researches clarifying the characteristics of elderly PD patients have been gradually accumulated, but there have been very few studies on “very” old–onset PD.
The term “elderly PD” includes both patients who have been on treatment for a long time and have become elderly, and those who have developed PD at old age. Characteristics of old–onset PD patients include severe motor and non–motor symptoms from the onset, rapid symptom progression and a short life expectancy, high risk of developing axial symptoms, hallucinations and dementia, while the lower risk of developing motor complications (wearing off and dyskinesia) and impulse control disorders. Neuropathological findings include a high incidence of Alzheimer's pathology as well as Lewy bodies. In terms of clinical feature, rigid–akinetic phenotype is significantly more common. In addition, pharmacokinetic changes specific to the elderly are also important.
The number of elderly PD patients is expected to increase rapidly in Japan, which is facing an unprecedented super–aging society. As a frontier for elderly PD patients, it is necessary to take the lead in establishing research results and evidence that contribute to the clinical management of elderly PD patients.
