Seniors with Parkinson's disease: initial medical treatment.

Parkinson's disease most often presents after age 60, and patients in this age group are best managed with levodopa therapy as the primary treatment modality. Unlike young-onset parkinsonism (onset <age 40), this older age group is much less prone to subsequent development of levodopa responsive instability (dyskinesias, fluctuations). When these problems do occur in seniors, they usually can be managed by medication adjustments. The treatment goal is to keep patients active and engaged; levodopa dosage should be guided by the patients' responses and not arbitrarily limited to low doses, which may compromise patients' lives.