Parkinson’s Disease and Parkinsonism in the Elderly

Editors: Jolyon Meara and William C. Koller
Cambridge University Press, 2000
ISBN 0 521 62884 9

Reviewed by Barry Goldlist, MD, FRCPC, FACP

This text is a collaboration between chapter authors and editors from the United Kingdom and the United States.

Of late, there has been an explosion of knowledge and literature in the broad field of movement disorders, so to stand out from this field, the text would have to be well written and truly focus on the elderly. Many texts simply state "condition X" is common in the elderly, and then present a discussion that could have been lifted from any general textbook.

This book is certainly well written. The first chapter gives a glossary of terms that is helpful, particularly for a non-neurologist. The second chapter, on the diagnosis of parkinsonism in the elderly by Professor Rodnitzky, is extremely well written. The chapter is organized in a way that follows normal clinical reasoning, and although concise, contains more than enough information for a generalist physician. Reading this chapter made me feel I was in the company of a master clinician. The third chapter is also very good. Although the neuropathological basis of PD is not age-specific, the chapter discusses specific geriatric issues such as comorbidity, clinical heterogeneity, age-related pattern of disease presentation and the nature of a comprehensive geriatric assessment as it relates to patients with PD. Specific problems related to the elderly are also stressed. There are individual chapters on essential tremor, gait apraxia and epidemiology, and there has been a concerted effort to focus on the elderly. The relatively minimal amount of repetition in the chapters is further evidence of high quality editing.

The numerous chapters on the role of rehabilitation professionals in the care of elderly PD patients really distinguishes this book from a more general text, and might make this text suitable for general neurologists who want specific details about handling older PD patients. It is certainly of value for generalists and geriatricians who manage elderly patients with PD. It is also probably of interest and value to rehabilitation professionals who work with PD patients.