Subthalamic nucleus deep brain stimulation in elderly patients–analysis of outcome and complications
Vesper, J., Haak, S., Ostertag, C., & Nikkhah, G. (2007). Subthalamic nucleus deep brain stimulation in elderly patients–analysis of outcome and complications , BMC Neurology. Mar 16; 7: 7.
The authors of this study readily acknowledged the benefit of DBS and set out to examine if there were differences in the successes as well as adverse event rates for DBS in an older (65+) and younger (<65) PD population. Both groups showed improvement in their motor scores across various points up to 24 months from surgery. Both groups also had improved quality of life and reduced need for medication after surgery. Immediately after surgery, the younger group had more improvement than the older group in completing tasks independently within the home. However, that difference was small and disappeared by the 6-month follow up. In regard to adverse events, it should be noted that there were few severe complications in either group. Nonetheless, the older group had more infections (4 vs. 1 out of 73) and a higher death rate (5 vs. 2) than the younger group. The authors concluded overall that DBS was effective for both age groups suggesting that there need not be an age limit for DBS. They suggested that both groups be screened for appropriate candidacy for DBS, especially as the older adults had more adverse infections than the younger group. The authors also noted that as DBS continues to be a treatment option in older adults that the group should be followed as long term effects are not as well studied in the literature.
Last month we reviewed an article (Derost et al., 2007) also addressing younger versus older adults in regard to effectiveness of DBS. It should be noted that the previous study used more measures, specifically related to Quality of Life, which may explain the difference in findings of these two studies. All else within the studies were comparable and suggestive that DBS is effective for both young and older adults with PD.