Neurosurgery is a surgical procedure that uses invasive techniques to diagnose, investigate and/or treat a neurological disorder, disease or injury. For example, to remove a brain tumour or insert a deep brain stimulation device. Neurosurgery, particularly deep brain stimulation of the subthalamic nucleus, is becoming increasingly used as a treatment option in PD.Unfortunately, it is unlikely that older patients will be suitable for neurosurgical interventions as most of these procedures primarily improve drug-induced dyskinesia or improve “off” time in patients with motor fluctuations, neither of which is a common situation in patients with late-onset disease. Additionally, cognitive impairment, which is the major contraindication to neurosurgery, is frequently already present in older patients. Deep brain stimulation also requires a considerable ongoing commitment from both the patient and neurosurgical team. Furthermore, even in older patients with a good initial response, disease progression may result in any benefit from neurosurgery being short-lived.