Clinical Characteristics of Geriatric Patients With de novo Parkinson’s Disease Compared with the Non-Geriatric Population: Adapting to Changes in the Era of Aging

Background: Parkinson’s disease (PD) is increasingly being diagnosed in older adults. Despite this trend, the clinical features of geriatric patients with PD are not thoroughly defined. This study aimed to compare the clinical characteristics of geriatric patients (aged ≥75 years) with de novo PD against those of non-geriatric patients (aged <75 years) newly diagnosed with PD. Methods: This retrospective analysis enrolled 110 patients aged 50 years or older with de novo PD from our hospital’s Parkinsonism registry between 2017 and 2023. Clinical evaluations included motor assessment via the Unified Parkinson’s Disease Rating Scale Part III and global cognitive function was measured using the Montreal Cognitive Assessment (MoCA). Nonmotor symptoms, including depression, anxiety, and fatigue, were assessed using other scales and autonomic dysfunction was assessed using the Scale for Outcomes in Parkinson’s Disease–Autonomic (SCOPA-AUT). Results: Geriatric patients with PD (n = 37) exhibited significantly lower cognitive performance (lower MoCA scores, p < 0.001) and more pronounced autonomic dysfunction (higher SCOPA-AUT scores, p = 0.0103) in comparison with non-geriatric PD patients (n = 73). In multivariate logistic regression analysis, lower MoCA scores (odds ratio OR: 0.7642, 95% confidence interval CI: 0.6712–0.8701, p < 0.001) and elevated SCOPA-AUT scores (OR: 1.0640, 95% CI: 1.0031–1.1286, p = 0.0391) emerged as significant independent predictors of geriatric PD. Conclusions: These findings reveal a distinct clinical phenotype among geriatric patients with de novo PD, underscoring the value of early detection and proactive management of cognitive and autonomic impairments in this group. The results further emphasize the need for individualized assessment and therapeutic interventions tailored to the specific requirements of geriatric patients with PD.