Impact of Functional Age on the Use of Dopamine Agonists in Patients With Parkinson Disease
Impact of Functional Age on the Use of Dopamine Agonists in Patients With Parkinson Disease
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DOI：
10.1097/01.nrl.0000215782.78763.fa
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发表时间：
2006-07
期刊：
影响因子：
--
通讯作者：
D. Silver
中科院分区：
文献类型：
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作者：
D. Silver
背景：帕金森病（PD）主要是一种神经退行性疾病，在美国影响多达150万人。它主要是老年人的疾病，必须解决这一患者群体的特殊治疗挑战。综述总结：人们普遍认为，70岁以上的PD患者的寿命比年轻患者短，并且由于他们在疾病过程中较少的药物暴露，因此发生治疗并发症的风险更低。因此，当运动症状开始致残时，老年患者通常会积极治疗。然而，最近的统计数据表明，有效的PD治疗有助于延长PD患者的寿命，这表明老年患者实际上可能有足够的药物暴露来引起对左旋多巴诱导的运动并发症的关注。如果是这种情况，医生应该考虑用多巴胺激动剂治疗老年PD患者，多巴胺激动剂比左旋多巴治疗有几个优点，其中最重要的是运动并发症的发生率较低。结论：多巴胺激动剂对老年患者安全有效，无论是单药治疗还是辅助治疗，尤其是需要长期治疗的患者，都具有许多优势。
Background:Parkinson disease (PD) is primarily a neurodegenerative disorder that affects as many as 1,500,000 people in the United States. It is predominantly a disease of the elderly, and special treatment challenges must be addressed in this patient population. Review Summary:It has been generally accepted that PD patients over the age of 70 will have a shorter lifespan than younger patients and are at less risk for developing treatment-emergent complications by virtue of their lower exposure to medication over the course of the disease. Consequently, elderly patients are often treated aggressively when motor symptoms start to become disabling. Recent statistics, however, suggest that effective treatments for PD have helped to increase the longevity of PD patients, suggesting that elderly patients may, in fact, have sufficient medication exposure to raise concern over levodopa-induced motor complications. If this is the case, physicians should consider treating their elderly PD patients with dopamine agonists, which have several advantages over levodopa therapy, not the least of which is a lower prevalence of motor complications. Conclusion:Dopamine agonists are safe and effective in elderly patients and offer numerous advantages when used as either monotherapy or adjunctive therapy, particularly in patients requiring long-term treatment.