The treatment of PD needs to be individualized; each patient presents with a unique set of symptoms, signs, response to medications, and a host of social, occupational, and emotional problems that need to be addressed. As mentioned above, a major goal is to keep the patient functioning independently as long as possible. The practical guidelines for how to direct treatment are to consider the patient's symptoms, the degree of functional impairment, and the expected benefits and risks of available therapeutic agents. Ask the patient what specific symptoms trouble him the most. Also, keep in mind that younger patients are more likely to develop motor fluctuations and dyskinesias; older patients are more likely to develop confusion, sleep-wake alterations, and psychosis from medications.
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