Parkinson's disease (PD) in the elderly: An example of geriatric syndrome (GS)?

PD is an age-related neurodegenerative disorder that affects as many as 1–2% of persons aged 60 years and older. In the latest decade, the approach to PD was dramatically changed. In fact, although for many years PD has been considered only ‘‘a disease that affects walking’’, with a key role of the neurotransmitter dopamine, recently the neurological approach has been substantially modified. The approach for this disease is not only a neurological issue. Given the complexity of its clinical aspects, such as depression, anxiety, dementia, sleep disorder, pneumonia dysfagia-related and malnutrition, a multidisciplinary evaluation and not just a neurological evaluation is needed. We suggest a n multidisciplinary approach for this old actor, underlying a subtle link between neurophatological stages of the disease (Braak’s classification) and clinical aspects (Braak’s stages 1 and 2 associated with the premotor phase; Braak’s stages 3–4 associated with the motor symptoms and Braak’s stages 5–6 associated with cognitive impairment). In addition, we emphasize the usefulness of geriatric evaluation for the identification of frail ‘‘in situ’’, frail, and disable status for improving care and treatment in this multifaceted disease.