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Background: Parkinson's disease (PD) is a prevalent neurodegenerative disorder among the elderly, with its incidence increasing as the population ages. Despite the predominance of patients with PD aged 75 years and older in clinical settings, limited research has focused on their rehabilitation. This study aimed to compare the clinical characteristics and rehabilitation outcomes of elderly patients aged 75 years and older. Methods: A retrospective analysis was conducted on 141 patients with PD aged 65 years and older who underwent intensive inpatient rehabilitation. Patients were categorized into two subgroups: the young-old group (65-74 years, n = 58) and the old-old group (≥75 years, n = 83). The rehabilitation program included daily 2 h sessions, 6 days a week, combining physical, occupational, and speech-language-hearing therapies to enhance functional impairments and activities of daily living (ADL). Clinical characteristics and rehabilitation outcomes were compared between these groups. Results: The old-old group exhibited significantly higher rates of sarcopenia, higher Unified Parkinson's Disease Rating Scale (UPDRS) scores, poorer balance scores and cognitive function, and lower ADL scores compared with the young-old group. However, both groups demonstrated significant improvements in UPDRS, Berg Balance Scale, 10 m walk test, and Functional Independence Measure scores, indicating enhanced motor function and ADL. Conclusions: Our retrospective study suggests that inpatient rehabilitation is associated with improvement in parkinsonism, motor symptoms, and ADL in patients with PD aged 75 years or older, highlighting the potential benefits of intensive rehabilitation even in advanced age. These findings underscore the need for prospective studies to confirm these effects. Trial registration: UMIN000056042 (last amendment 5 November 2024, retrospectively registered).
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