I was listening to Dr. Stanley Fahn, supposed to be a world leading expert in movement disorders. He says, "Elderly people have poor tolerance to the agonist compared to levodopa: more hallucinations and confusion. Also, the prime reason for starting an agonist is to delay motor fluctuations; these are less common in the elderly population. I avoid dopamine agonists in patients with any cognitive decline, which is predominantly in the elderly population." Any thoughts?
Also, here is the link to his talk: