Parkinson's disease in the elderly.

An 82 year old woman was admitted to a rehabilitation hospital after sustaining a pelvic fracture. She had a past history of osteoporosis and chronic lower back pain treated with epidural steroids. For the past two years she had had several falls associated with fractures. She also reported drooling, difficulties swallowing, gait shuffling and freezing, and tremor in the left hand, more at rest than with action. She had no cognitive impairment. She was started on a small dose of levodopa/ carbidopa 25/100, a half three times a day. She responded very well, stopped drooling, and had improvement in swallowing, gait, and tremor. However, her balance remained impaired and she continued to need a walker.