title: Causes and factors related to dopamine agonist withdrawal in Parkinson's disease.
abstract: Although dopamine agonists (DAs) are useful in Parkinson's disease (PD), they are not frequently used in elderly patients due to adverse effects. However, there is a lack of evidence because few elderly PD patients are enrolled in clinical trials.
  
  
  
  The aims of this study were to analyze the reasons of DA withdrawal (DAW) in a group of PD patients in clinical practice and to identify the related factors. Specifically, we studied the effect of age, comorbidity, and polypharmacy as potential risk factors for DAW.
  
  
  
  A retrospective chart review of the follow-up (from May, 2012 to March, 2015) of a subgroup of PD patients receiving a DA (n = 68; 60.3% males, 69.3 ± 9.2 years old) from a cohort (n = 150) previously studied in detail in 2012 was used to identify predictive factors of DAW.
  
  
  
  The DAW percentage was 18.2% (12/66; follow-up of 690.2 ± 232.6 days). DAW causes were cognitive impairment (3), reduction therapy (3), hallucinations (2), dyskinesia (2), and excessive diurnal somnolence (2). Only a higher levodopa daily dose (HR 1.003; 95% CI 1.001-1.006; P = 0.044) was an independent predictor of DAW after adjustment for other explanatory variables.
  
  
  
  The frequency of DAW was low. Advanced age alone is not a contraindication to the administration of DAs.
authors.affiliation: Section of Neurology Complejo Hospitalario Universitario de Ferrol (CHUF) Hospital A. Marcide Ferrol Spain.
authors.forename: Ester Suárez
authors.initials: ES
authors.lastname: Castro
authors.affiliation: Section of Neurology Complejo Hospitalario Universitario de Ferrol (CHUF) Hospital A. Marcide Ferrol Spain.
authors.forename: Diego
authors.initials: D
authors.lastname: Santos-García
authors.affiliation: Section of Neurology Complejo Hospitalario Universitario de Ferrol (CHUF) Hospital A. Marcide Ferrol Spain.
authors.forename: Teresa
authors.initials: T
authors.lastname: de Deus Fonticoba
authors.affiliation: Section of Neurology Complejo Hospitalario Universitario de Ferrol (CHUF) Hospital A. Marcide Ferrol Spain.
authors.forename: Irene
authors.initials: I
authors.lastname: Expósito Ruíz
authors.affiliation: Section of Neurology Complejo Hospitalario Universitario de Ferrol (CHUF) Hospital A. Marcide Ferrol Spain.
authors.forename: Cintia
authors.initials: C
authors.lastname: Tuñas Gesto
authors.affiliation: Section of Neurology Complejo Hospitalario Universitario de Ferrol (CHUF) Hospital A. Marcide Ferrol Spain.
authors.forename: Mercedes Macías
authors.initials: MM
authors.lastname: Arribí
mesh_terms: D000367:Age Factors; D000368:Aged; D003072:Cognition Disorders / Q000139:chemically induced; D015331:Cohort Studies; D015897:Comorbidity; D000075202:Contraindications; D018491:Dopamine Agonists / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D010300:Parkinson Disease / Q000188:drug therapy*; D019338:Polypharmacy; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D018491:Dopamine Agonists
keywords: Age; Parkinson′s disease; comorbidity; dopamine agonist; polypharmacy; tolerability