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A 62-year-old man with newly diagnosed Parkinson's disease presents with mild resting tremor, rigidity, and bradykinesia but is still functionally independent. He asks whether starting levodopa now will accelerate motor complications (wearing off, dyskinesias) compared to initiating MAO-B inhibitors or dopamine agonists first. What does current evidence say about early vs delayed levodopa, and how should age, occupation, and disease severity guide this decision?
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