In developed countries we live in a unique period where the proportion of elderly people is higher than at any other time; indeed, the proportion of the very old is increasing at a greater rate than any other age group. Parkinson’s disease is a good example of an age-related disease; two thirds of the patients are over the age of 70. And yet it is surprising how little attention is paid to how the age of the patient may influence the diagnosis and management of Parkinson’s disease, and other age-related disorders.

Market research in the UK indicates that two thirds of new prescriptions for Parkinson’s disease drugs are initiated by geriatricians. The emergence of specialised multidisciplinary Parkinson’s disease clinics as a feature of most comprehensive geriatric services, together with the development of the Parkinson’s Disease Academy (http://www.pdsection.org.uk) to train geriatricians to run such services, is one of the success stories of my specialty. It has also resulted in the convergence between the neurological and the geriatric approach to Parkinson’s disease. The MacMahon Thomas criteria recognise the clinical …