Senile parkinsonism, a study of current treatment

In a survey of all 2069 in-patients at 14 geriatric centres, 249 patients were found to have received drugs for the treatment of parkinsonism. There was a wide variation in point prevalence which varied from 4.6% to 22.6% between centres. Levodopa, usually in combination with a decarboxylase inhibitor, was the most frequently prescribed drug. Compared with the recommendations for its use in Parkinson's diseases, over 75% of patients received inadequate and widely spaced doses. Furthermore, dopamine antagonists were concurrently prescribed to one-third of patients who received levodopa. There was a high incidence of treatment failure (30%), and a low incidence of drug-induced dyskinesia (3%). Dementia was closely associated with the onset of parkinsonism. These findings suggest that many of these patients did not have Parkinson's disease but rather rigid-akinetic syndromes associated with degenerative brain disease. The treatment of parkinsonism in the elderly requires reevaluation.