Parkinson’s Disease in the Elderly

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Parkinson’s disease (PD) is known as an older person’s disease, as it is most commonly diagnosed in people over the age of 60 (only 5% of all cases are diagnosed before the age of 60). PD is the second most common age-related nerve degenerating disease after Alzheimer’s disease. The incidence of PD is 1% of the population over the age of 60, and this increases to 5% of the population over the age of 85, illustrating that aging is the biggest risk factor for developing PD.1

Why Parkinson’s disease occurs more in the elderly

The biggest risk factor for PD is age. While the exact cause of PD remains unknown, scientists believe it results from a combination of genetic and external factors, although it is important to note that many genetic or external factors remain to be discovered and require more scientific research.1

PD affects multiple areas of the body and brain. Death of nerve cells (neurons) in a brain region called the substantia nigra pars compacta is largely responsible for motor symptoms including tremor, rigidity, and loss of spontaneous movement. Dopamine is a chemical messenger (neurotransmitter) that transmits signals for producing smooth, purposeful movement. Research has shown that the substantia nigra pars compacta shows more loss of neurons than other areas of the brain. These neurons appear to be more sensitive to some toxins. Many of these toxins target an organelle in neurons called mitochondria which are responsible for generating ATP, the source of energy in a cell. In addition, during aging there is a decline in the function of organelles that are responsible for clearing up and removing damaged proteins in neurons.  Also, over time, there is a build up of the alpha-synuclein protein which forms Lewy bodies that damage neurons.

It is estimated that people with PD have lost 60-80% or more of the neurons that produce dopamine by the time motor symptoms appear.1,2 As a result, over extensive periods of time, the reduced function of mitochondria and other organelles in the cell and the build up abnormal forms of alpha-synuclein may cause neuron loss. It is only after extensive neuron loss over time that the motor symptoms emerge.

Symptoms of Parkinson’s disease in the elderly

The symptoms of PD in elderly patients are similar to people with PD of all ages. There are both motor and non-motor symptoms that may be experienced in elderly patients with PD, including:

Treatment of Parkinson’s disease in the elderly

While there is not currently treatment that can cure or delay the progression of PD, the symptoms can often be managed effectively with treatment. Senior-aged patients are much less likely to experience side effects with levodopa therapy compared to younger PD patients, and the goals of treatment of PD in the elderly are to maintain the patient’s activity level and optimize quality of life. Once patients with PD develop sedentary lifestyles due to their disease, it is difficult to reverse.3

view references
  1. Reeve A, Simcox E, Turnbull D. Ageing and Parkinson’s disease: why is advancing age the biggest risk factor? Ageing Res. Rev., 2014 Mar;14(100):19–30.
  2. Parkinson’s Disease Foundation. Accessed online on 12/6/16 at http://www.pdf.org/en/about_pd.
  3. Ahlskog JE. Seniors with Parkinson's disease: initial medical treatment. J Clin Neurol. 2010 Dec; 6(4): 159–166. Published online 2010 Dec 31. doi: 3988/jcn.2010.6.4.159
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Written by: Emily Downward | Last reviewed: March 2017
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