Skip to main content
SpringerLink
Log in

La maladie de Parkinson de début tardif : différences et similitudes par rapport à celle des sujets plus jeunes ?

Late first signs of Parkinson’s disease: differences and similarities compared to younger subjects

  • Article Original / Original Article
  • Published:
Les cahiers de l'année gérontologique

Résumé

La prévalence et l’incidence de la maladie de Parkinson (MP) augmentent avec l’âge. Les formes à début tardif se distinguent sur le plan moteur par une moindre fréquence des dyskinésies et fluctuations, au moins les premières années, et par l’existence de signes axiaux, surtout troubles de la marche, de la posture et de l’équilibre, peu sensibles à la lévodopa et facteurs de chutes. Des comorbidités, en particulier vasculaires, peuvent aggraver le tableau clinique. Les sujets âgés ont un risque élevé de développer des troubles cognitifs, légers (MCI) ou sévères entrant dans le cadre d’une démence. Les syndromes hallucinatoires chroniques accompagnent très fréquemment la démence. Les troubles psychiques non spécifiques du sujet âgé doivent être dépistés, en raison de leur fréquence et/ou de leur gravité potentielle : syndromes anxieux, dépressifs, et troubles du contrôle des impulsions. Enfin une hypotension orthostatique, liée à la MP ou aux traitements, des troubles mictionnels et des altérations du sommeil émaillent souvent l’évolution. La diffusion des lésions à des systèmes non-dopaminergiques, possiblement conjuguée aux effets du vieillissement, explique l’aggravation rapide de la maladie au cours des dernières années de son évolution.

Abstract

Prevalence and incidence of Parkinson’s disease (PD) increase with age. Late onset PD is characterized by a lower incidence of fluctuations and dyskinesia, at least during the first years of the disease, and by frequent axial impairment, including gait and posture disturbances. These features are not levodopa responsive and may cause repetitive falls. Vascular comorbidities may aggravate the clinical picture. Patients with late onset PD have a higher risk to develop cognitive impairment, either subtle (MCI) or severe, in the context of dementia. A chronic hallucinatory syndrome is frequently associated to dementia. Although they are not specific of late onset PD, some mental disorders have to be identified because of their frequency and/or their potentially severe consequences. Finally, patients with late onset PD often present with orthostatic hypotension, urinary disturbances, and sleep complaints. The progression of the lesions to non-dopaminergic systems, associated with the neurobiological effects of ageing, might explain the accelerated course of the disease in the last years of the evolution.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Références

  1. de Lau LML, Breteler MMB (2006) Epidemiology of Parkinson’s disease. Lancet Neurol 5: 525–535

    Article  PubMed  Google Scholar 

  2. Bonnet AM, Loria Y, Saint-Hilaire MH, et al (1987) Does longterm aggravation of Parkinson’s disease result from nondopaminergic lesions? Neurology 37: 1539–1542

    Article  PubMed  CAS  Google Scholar 

  3. Gibb WR, Lees AJ (1988) A comparison of clinical and pathological features of young- and old-onset Parkinson’s disease. Neurology 38: 1402–1406

    Article  PubMed  CAS  Google Scholar 

  4. Petit H, Vermersch P, Pasquier F (1992) Some clinical aspects of late onset parkinsonism. Clin Neurol Neurosurg 94(Suppl):S137–S138

    Article  PubMed  Google Scholar 

  5. Diederich NJ, Moore CG, Leurgans SE, et al (2003) Parkinson disease with old age-onset: a comparative study with subjects with middle-age onset. Arch Neurol 60:529–533

    Article  PubMed  Google Scholar 

  6. Wickremaratchi MM, Knipe MD, Sastry BS, et al (2011) The motor phenotype of Parkinson’s disease in relation to age at onset. Mov Disord 26:457–463

    Article  PubMed  Google Scholar 

  7. Friedman A (1994) Old-onset Parkinson’s disease compared with young-onset disease: clinical differences and similarities. Acta Neurol Scand 89:258–261

    Article  PubMed  CAS  Google Scholar 

  8. Levy G, Louis ED, Cote L, et al (2005) Contribution of aging to the severity of different motor signs in Parkinson disease. Arch Neurol 62:467–472.

    Article  PubMed  Google Scholar 

  9. Ku S, Glass GA (2010) Age of Parkinson’s disease onset as a predictor for the development of dyskinesia. Mov Disord 25:1177–1182

    Article  PubMed  Google Scholar 

  10. Evans JR, Mason SL, Williams-Gray CH, et al (2011) The natural history of treated Parkinson’s disease in an incident, community based cohort. J Neurol Neurosurg Psychiatry 82: 1112–1118

    Article  PubMed  Google Scholar 

  11. Post B, Muslimovic D, van Geloven N, et al (2011) Progression and prognostic factors of motor impairment, disability and quality of life in newly diagnosed Parkinson’s disease. Mov Disord 26:449–456

    Article  PubMed  Google Scholar 

  12. Alves G, Wentzel-Larsen T, Aarsland D, Larsen JP (2005) Progression of motor impairment and disability in Parkinson disease: a population-based study. Neurology 65:1436–1441

    Article  PubMed  Google Scholar 

  13. de la Fuente-Fernandez R, Schulzer M, Kuramoto L, et al (2011) Age-specific progression of nigrostriatal dysfunction in Parkinson’s disease. Ann Neurol 69: 803–810

    Article  PubMed  Google Scholar 

  14. Rampello L, Alvano A, Battaglia G, et al (2005) Different clinical and evolutional patterns in late idiopathic and vascular parkinsonism. J Neurol 252:1045–1049

    Article  PubMed  CAS  Google Scholar 

  15. Lee SJ, Kim JS, Lee KS, et al (2009) The severity of leukoaraiosis correlates with the clinical phenotype of Parkinson’s disease. Arch Gerontol Geriatr 49:255–259

    Article  PubMed  Google Scholar 

  16. Bohnen NI, Albin RL (2011) White matter lesions in Parkinson disease. Nat Rev Neurol 7: 229–236

    Article  PubMed  Google Scholar 

  17. Bohnen NI, Müller ML, Zarzhevsky N, et al (2011) Leucoaraiosis, nigrostriatal denervation and motor symptoms in Parkinson’s disease. Brain 134:2358–2365

    Article  PubMed  Google Scholar 

  18. Litvan I, Goldman JG, Tröster AI, et al (2012) Diagnostic criteria for mild cognitive impairment in Parkinson’s disease: Movement Disorder Society Task Force guidelines. Mov Disord 27:349–356

    Article  PubMed  Google Scholar 

  19. Williams-Gray CH, Foltynie T, Brayne CEG, Robbins TW, Barker RA (2007) Evolution of cognitive dysfunction in an incident Parkinson’s disease cohort. Brain 130:1787–17898

    Article  PubMed  CAS  Google Scholar 

  20. Goetz CG, Emre M, Dubois B (2008) Parkinson’s disease dementia: definitions, guidelines, and research perspectives in diagnosis. Ann Neurol 64(suppl):S81–S92

    PubMed  Google Scholar 

  21. Emre M, Aarsland D, Brown R, et al (2007) Clinical diagnostic criteria for dementia associated with Parkinson’s disease. Mov Disord 22:1689–1707

    Article  PubMed  Google Scholar 

  22. Kehagia AA, Baker RA, Robbins TW (2010) Neuropsychological and clinical heterogeneity of cognitive impairment and dementia in Parkinson’s disease. Lancet Neurol 9:1200–1213

    Article  PubMed  Google Scholar 

  23. Aarsland D, Ballard CG, Halliday G (2004) Are Parkinson’s disease with dementia and dementia with Lewy bodies the same entity? J Geriatr Psychiatry Neurol 17:137–145

    Article  PubMed  Google Scholar 

  24. Diederich NJ, Fénelon G, Stebbins G, Goetz CG (2009) Hallucinations in Parkinson disease. Nat Rev Neurol 5:331–342

    Article  PubMed  CAS  Google Scholar 

  25. Fénelon G (2011) Troubles psychiques et comportementaux et leurs traitements. In Defebvre L, Vérin M (eds). La maladie de Parkinson (2e édition). Masson, Paris

    Google Scholar 

  26. Ravina B, Marder K, Fernandez HH, et al (2007) Diagnostic Criteria for Psychosis in Parkinson’s disease: Report of an NINDS/NIMH Work Group. Mov Disord 22:1061–1068

    Article  PubMed  Google Scholar 

  27. Forsaa EB, Larsen JP, Wentzel-Larsen T, et al (2010) A 12-year population-based study of psychosis in Parkinson disease. Arch Neurol 67:996–1001

    Article  PubMed  Google Scholar 

  28. Wüllner U, Schmitz-Hübsch T, Antony G, et al (2007) Autonomic dysfunction in 3414 Parkinson’s disease patients enrolled in the German Network on Parkinson’s disease (KNP e.V.): the effect of ageing. Eur J Neurol 14:1405–1408

    Article  PubMed  Google Scholar 

  29. Kempster PA, O’sullivan SS, Holton JL, et al (2010) Relationships between age and late progression of Parkinson’s disease: a clinico-pathological study. Brain 133:1755–1762

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Assistance publique hôpitaux de Paris, Hôpital Henri Mondor, 51, avenue du Maréchal de Lattre de Tassigny, F-94000, Créteil, France

    G. Fénelon

  2. INSERM U955, E01, Créteil, France

    G. Fénelon

  3. Fondation ophtalmologique Adolphe de Rotschild, 25-29, rue Manin, F-75019, Paris, France

    J. -P. Brandel

Authors
  1. G. Fénelon
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. J. -P. Brandel
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to G. Fénelon.

About this article

Cite this article

Fénelon, G., Brandel, J.P. La maladie de Parkinson de début tardif : différences et similitudes par rapport à celle des sujets plus jeunes ?. cah. année gerontol. 4, 36–42 (2012). https://doi.org/10.1007/s12612-012-0268-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12612-012-0268-8

Mots clés

Keywords

Search

Navigation