Parkinson's disease

Abstract

Parkinson's disease occurs mainly in elderly patients. Among those aged over 80 years, up to 2.6 % are diagnosed with Parkinson's disease (de Rijk et al. 2000). At onset of the disease, approximately 70 % of individuals were 50 years or older. As for dementia, a significant increase in its incidence is expected, with the consequence that in 2030 twice the number of patients will have to be treated for Parkinson's disease if compared with current rates. Besides these data concerning primary Parkinson's disease, there will also be an even more increasing prevalence of nonprimary parkinsonian syndromes. To date, nonprimary parkinsonian syndromes or partial symptoms thereof are reaching prevalence rates up to 51 % in some subgroups of the elderly population (Bennett et al. 1996). Among nonprimary forms, drug-induced syndromes are most common, and other causes such as postinfectious, metabolic, and toxic ones are rare. The prevalence of drug-induced parkinsonian syndromes remains less clear, but reports found it to be up to 50 % in nursing home residents (Stephen and Williamson 1984). As this figure seems alarmingly high, ruling out drug-induced parkinsonian syndromes is very important as otherwise correct treatment opportunities will be missed, causing serious disadvantages for the patient. Needless to say, in drug-induced parkinsonian syndromes, the responsible drug has to be identified and discontinued instead of adding levodopa treatment.