Parkinson’s Disease in Primary Care: A Practical Canadian Primer

Abstract

Parkinson’s disease (PD) is a progressive neurodegenerative disorder that is increasingly encountered in Canadian primary care. National surveillance data estimate that over 110,000 Canadians are living with Parkinsonism, with incidence rising steadily as the population ages. Approximately 80% of new diagnoses occur after the age of 65 years, making PD highly relevant to geriatric-focused primary care practice. For family physicians, PD represents not only a diagnostic challenge but also a longitudinal care responsibility that intersects with multimorbidity, polypharmacy, fall risk, and caregiver burden.

The diagnosis of PD remains clinical. It requires recognition of Parkinsonism, defined as bradykinesia in combination with rest tremor and/or rigidity, and on an assessment of whether the clinical features support idiopathic PD versus alternative etiologies such as drug-induced, vascular, or atypical Parkinsonism. In primary care, a structured approach that incorporates a focused history, bedside motor examination, and screening for non-motor symptoms can significantly improve diagnostic accuracy.

Management begins with patient education, early initiation of exercise, and symptom-guided pharmacotherapy. Levodopa remains the most effective treatment for motor symptoms and should not be delayed once functional impairment emerges. Primary care clinicians are well positioned to initiate therapy, monitor therapeutic response, and coordinate multidisciplinary care, particularly in regions where access to neurology is limited.