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Parkinson's disease (PD) is a common disease of older adults. It presents a unique set of anesthetic challenges. With increasing life expectancy and the rapid growth of oldest-old patients, it is now more likely for anesthesiologists to encounter older patients with PD. Due to polypharmacy in the older adults with PD a potential for drug interactions during and after surgery needs to be considered. More data from prospective, multicenter trials about short-and long-term outcomes of anesthesia in PD patients are needed.