Parkinson病をもった高齢者をどう「み」るか　～エビデンスの空白地帯から眺める～

抄録

The average life expectancy of Japanese people in 2021 is 81.47 years for men and 87.57 years for women. Because of recent improvements in nutrition and sanitation, as well as the advances in medical care, it is predicted that the average life expectancy will reach 100 years, so–called the era of 100–year–life. Although the lifespan is getting longer, very few people will be free from disorder throughout their lives, and the majority will live with various diseases, especially chronic diseases.

Parkinson disease (PD) is the second most common, progressive neurodegenerative disorder, and its global incidence is on the rise, due to the aging of the world's population. “Elderly PD patients” are divided into two groups : patients with PD those who have been living with PD for a long time and those who develop PD at an old age. In the clinical practice for the elderly with PD, it is indispensable for clinicians to keep complex physical conditions, such as pharmacokinetics, comorbidities, and polypharmacy in “the elderly” in mind, as well as “PD” itself. In addition, reduced physical activity in the elderly could make it difficult to attend distant medical facilities; therefore, clinicians should provide PD care in their lives locally. In other words, the essence of clinical practice for the elderly with PD is not only to provide specialized “PD” treatment but also to treat and care for “the elderly”.

In general, it is difficult to establish evidence in the medical field for the elderly, because each elderly has a wide variety of background factors, including comorbidities or polypharmacy, which could be biases in the clinical research. Japan is one of the first countries in the world to face a super–aging society, and we are in a position to establish evidence about the clinical practice for “the elderly patients with PD”. We need to discuss what we can and should do for the elderly patients with PD and to provide evidence, preparing for the world's PD pandemic.