title: Treatment of advanced Parkinson's disease.
abstract: Patients at late stage Parkinson's disease (PD) develop several motor and nonmotor complications, which dramatically impair their quality of life. These complications include motor fluctuations, dyskinesia, unpredictable or absent response to medications, falls, dysautonomia, dementia, hallucinations, sleep disorders, depression, and psychosis. The therapeutic management should be driven by the attempt to create a balance between benefit and side effects of the pharmacological treatments available. Supportive care, including physical and rehabilitative interventions, speech therapy, occupational therapy, and nursing care, has a key role in the late stage of disease. In this review we discuss the several complications experienced by advance PD patients and their management. The importance of an integrative approach, including both pharmacological and supportive interventions, is emphasized.
authors.affiliation: New York University School of Medicine, Department of Neurology, Division of Movement Disorders, New York, NY 10016, USA.
authors.forename: Sara
authors.initials: S
authors.lastname: Varanese
authors.forename: Zoe
authors.initials: Z
authors.lastname: Birnbaum
authors.forename: Roger
authors.initials: R
authors.lastname: Rossi
authors.forename: Alessandro
authors.initials: A
authors.lastname: Di Rocco