Challenges in managing late-stage Parkinson’s disease Practical approaches and pitfalls

Abstract

Background Parkinson’s disease is a universally progressive neurodegenerative disease. People living with Parkinson’s disease for many years face progression from earlyto mid to late-stage Parkinson’s disease (LSPD). While levodopa-responsive, predominantly motor features constitute the majority of symptom burden in earlystage Parkinson’s disease, the disability in LSPD is characterised mainly by nonmotor symptoms, which may be poorly levodopa responsive.