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December 2003

Parkinson Disease With Old-Age Onset

Arch Neurol. 2003;60(12):1814-1815. doi:10.1001/archneur.60.12.1814

In a recent study, Diederich et al1 compared 43 patients with Parkinson disease (PD) and old-age onset (≥78 years) with those who had middle-age disease onset (43-66 years). The duration of illness was comparable in both groups (mean, 5.1 vs 5.5 years), but PD motor score in patients with old-age onset was more severe, and they had more comorbidites than those with earlier disease onset (56% vs 25%; P = .002). These data indicate the importance of delineating the confounding influences of aging and comorbidities in PD. They can only in part be confirmed by our recently published study of 200 patients with autopsy-confirmed PD (96 men and 104 women; mean ± SD age at onset, 68.6 ± 9.5 years; mean ± SD disease duration, 8.4 ± 9.5 years).2 From this cohort, we compared 32 patients (12 men and 20 women) who had old-age onset (mean ± SD, 82.4 ± 3.2 years; range, 78-94 years) with 94 patients with middle-age onset (mean ± SD, 61.8 ± 9.8 years; range, 44-66 years). The duration of old-age onset in patients with PD, ranging from 1 to 10 years (mean ± SD, 4.3 ± 2.2 years), was significantly shorter than in patients with middle-age onset (mean ± SD, 10.1 ± 9.3 years; range, 2-28 years).