• Online Features  This Article  • Full text  • PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (35)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Topic Collections  • Aging/ Geriatrics  • Neurology  • Movement Disorders  • Parkinson Disease/ Parkinsonian Disorders  • Alert me on articles by topic  Social Bookmarking   What's this?

Gilberto Levy, MD, MS

Arch Neurol. 2007;64(9):1242-1246.

Twentieth-century hypotheses attributing a substantive role to aging in Parkinson disease (PD) pathogenesis have been countered by evidence from clinical, pathological, and biochemical investigations. However, age influences the clinical progression of PD. Several studies have demonstrated that advancing age is associated with a faster rate of motor progression, decreased levodopa responsiveness, more severe gait and postural impairment, and more severe cognitive impairment and the development of dementia in patients with PD. A model for the relationship between PD and aging is proposed that incorporates the following 3 elements: (1) There occurs a superposition of a topographic gradient of neuronal loss in brainstem and basal forebrain structures related to the disease process and an aging-related temporal gradient. (2) While PD is a chronic progressive disorder, the most important determinant of clinical progression is advancing age rather than disease duration. (3) The effects of the disease process and aging on nondopaminergic structures involve a biologic interaction. The model implies that understanding the degenerative process in nondopaminergic structures in PD as it relates to molecular mechanisms accompanying the aging of the nervous system may create opportunities for interventions affecting the clinical progression of the disease.

Author Affiliation: Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, New York.

CiteULike    Connotea    Delicious    Digg    Facebook    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

The natural history of treated Parkinson's disease in an incident, community based cohort
Evans et al.
J. Neurol. Neurosurg. Psychiatry 2011;82:1112-1118.
ABSTRACT | FULL TEXT  

Dementia in Parkinson's disease: a 20-year neuropsychological study (Sydney Multicentre Study)
Reid et al.
J. Neurol. Neurosurg. Psychiatry 2011;82:1033-1037.
ABSTRACT | FULL TEXT  

Leucoaraiosis, nigrostriatal denervation and motor symptoms in Parkinson's disease
Bohnen et al.
Brain 2011;134:2358-2365.
ABSTRACT | FULL TEXT  

What predicts mortality in Parkinson disease?: A prospective population-based long-term study
Forsaa et al.
Neurology 2010;75:1270-1276.
ABSTRACT | FULL TEXT  

A 12-Year Population-Based Study of Psychosis in Parkinson Disease
Forsaa et al.
Arch Neurol 2010;67:996-1001.
ABSTRACT | FULL TEXT  

Longitudinal progression of sporadic Parkinson's disease: a multi-tracer positron emission tomography study
Nandhagopal et al.
Brain 2009;132:2970-2979.
ABSTRACT | FULL TEXT  

The Parkinson chimera
Lees
Neurology 2009;72:S2-S11.
ABSTRACT | FULL TEXT  

Overview of the Extranigral Aspects of Parkinson Disease
Lim et al.
Arch Neurol 2009;66:167-172.
ABSTRACT | FULL TEXT  

Management of Parkinson's disease in older women
Price and Shulman
Menopause Int 2008;14:38-39.
ABSTRACT | FULL TEXT