Introduction

Trying to unravel the complex health needs of elderly people is a major task faced by health care systems throughout the world, made all the more important by the fact that this group is a disproportionately high consumer of health care resources. Not only industrialized societies, but also developing countries, are facing a demographic challenge as life expectancy increases. The health needs of this group are complex and variable, reflecting the extreme heterogeneity of elderly people. However, all too often care tends to be fragmented and haphazard, reflecting and reinforcing ageist values.

The health and social needs of elderly patients with Parkinson's disease (PD) can be analysed in terms of specific needs related to PD and also in terms of general needs arising from any chronic illness in an elderly person. This chapter will not attempt to give definitive answers to what is needed to meet the health and social needs of patients with PD. It will instead try to give a brief description of the way in which services have developed for patients with PD and how research might best address the future development of such services.

Demographic changes

The proportion of populations throughout the world aged 65 and over is estimated to increase substantially into the next century. This change results from a slowing down of mortality rates, a decline in fertility rates and from advances in medical care and public health.