Treatment of Parkinson’s Disease and Parkinsonism in the Elderly

Parkinson’s disease (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. Given the complexity of its clinical aspects, such as depression, constipation, anxiety, dementia, sleep disorder, pneumonia dysfagia-related and malnutrition, a multidisciplinary evaluation, including a geriatric muldimensional evaluation, and not just a neurological evaluation is needed. We suggest a new multidisciplinary approach for this old actor, describing specific pharmacological approach based on the Braak’s stages of the disease. Guidelines for caring Parkinson’s disease has been developed, but specific approaches in case of elderly patients are insufficient or need uploaded. In addition, we emphasize the usefulness of geriatric evaluation for the identification of status at risk of hyperkinetic acute delirium that include motor and cognitive evaluation for the decision-making of this multifaceted disease.