title: [Geriatric particularities of Parkinson's disease: Clinical and therapeutic aspects].
abstract: Parkinson's disease (PD) is a frequent and complex progressive neurological disorder that increases in incidence with age. Although historically PD has been characterized by the presence of progressive dopaminergic neuronal loss of the substantia nigra, the disease process also involves neurotransmitters other that dopamine and regions of the nervous system outside the basal ganglia. Its clinical presentation in elderly subjects differs from that in younger subjects, with more rapid progression, less frequent tremor, more pronounced axial signs, more frequent non-motor signs linked to concomitant degeneration of non-dopaminergic systems, and more frequent associated lesions. Despite the high prevalence of PD in elderly subjects, few therapeutic trials have been conducted in geriatric patients. Nevertheless, to improve functional disability while ensuring drug tolerance, the principles of optimized and multidisciplinary clinical management have to be known. The aim of this review is to provide an update on clinical and therapeutic features of PD specifically observed in elderly subjects.
authors.affiliation: Service de neurologie et de neurophysiologie clinique, CHU de Tours, 2, boulevard Tonnellé, 37044 Tours cedex 9, France; Université François-Rabelais, 37000 Tours, France; Inserm U930, 37044 Tours cedex 9, France. Electronic address: jeremie.belin@etu.univ-tours.fr.
authors.forename: J
authors.initials: J
authors.lastname: Belin
authors.affiliation: Service de neurologie, CHU de Poitiers, 2, rue de la Milétrie, 86000 Poitiers, France.
authors.forename: J L
authors.initials: JL
authors.lastname: Houéto
authors.affiliation: Université François-Rabelais, 37000 Tours, France; Inserm U930, 37044 Tours cedex 9, France; Service de médecine interne gériatrique, CHU de Tours, 2, boulevard Tonnellé, 37044 Tours cedex 9, France.
authors.forename: T
authors.initials: T
authors.lastname: Constans
authors.affiliation: Université François-Rabelais, 37000 Tours, France; Inserm U930, 37044 Tours cedex 9, France; Service de médecine interne gériatrique, CHU de Tours, 2, boulevard Tonnellé, 37044 Tours cedex 9, France; Centre mémoire de ressources et de recherche (CMRR) de la région Centre, CHU de Tours, 2, boulevard Tonnellé, 37044 Tours cedex 9, France.
authors.forename: C
authors.initials: C
authors.lastname: Hommet
authors.affiliation: Service de neurologie et de neurophysiologie clinique, CHU de Tours, 2, boulevard Tonnellé, 37044 Tours cedex 9, France; Université François-Rabelais, 37000 Tours, France; Inserm U930, 37044 Tours cedex 9, France.
authors.forename: B
authors.initials: B
authors.lastname: de Toffol
authors.affiliation: Université François-Rabelais, 37000 Tours, France; Inserm U930, 37044 Tours cedex 9, France; Service de médecine interne gériatrique, CHU de Tours, 2, boulevard Tonnellé, 37044 Tours cedex 9, France; Centre mémoire de ressources et de recherche (CMRR) de la région Centre, CHU de Tours, 2, boulevard Tonnellé, 37044 Tours cedex 9, France.
authors.forename: K
authors.initials: K
authors.lastname: Mondon
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D003937:Diagnosis, Differential; D018450:Disease Progression; D006801:Humans; D010300:Parkinson Disease / Q000453:epidemiology / Q000503:physiopathology* / Q000523:psychology / Q000628:therapy*
keywords: Dementia; Démence; Elderly; Levodopa; Lévodopa; Maladie de Parkinson; Parkinson's disease; Sujet âgé; Thérapeutique; Treatment