Dementia associated with Parkinson’s disease: Applying the Movement Disorder Society Task Force criteria

• Published in: Parkinsonism & related disorders 2011-09, Vol.17 (8), p.621-624
• Main Authors: Martinez-Martin, P, Falup-Pecurariu, C, Rodriguez-Blazquez, C, Serrano-Dueñas, M, Carod Artal, F.J, Rojo Abuin, J.M, Aarsland, D
• Format: Article
• Language: English
• Subjects: Advisory Committees - standards; Aged; Aged, 80 and over; Criteria; Cross-Sectional Studies; Dementia - diagnosis; Dementia - epidemiology; Dementia - psychology; Dementia associated with Parkinson’s disease; Diagnosis; Diagnostic and Statistical Manual of Mental Disorders; Female; Humans; Internationality; Male; Medicin och hälsovetenskap; Middle Aged; Movement Disorders - diagnosis; Movement Disorders - epidemiology; Movement Disorders - psychology; Neurology; Parkinson Disease - diagnosis; Parkinson Disease - epidemiology; Parkinson Disease - psychology; Parkinson’s disease; Sensitivity; Societies, Medical - standards
• ISSN: 1353-8020; 1873-5126; 1873-5126
• DOI: 10.1016/j.parkreldis.2011.05.017

Abstract Background Diagnostic criteria and procedures for dementia in Parkinson’s disease (PDD) have been proposed by a Movement Disorders Society Task Force (MDS-TF). The objective of this study was to explore the utility of the new MDS-TF criteria and procedures in clinical practice. Methods Two hundred ninety nine PD patients (36.5% with PDD as per MDFS-TF criteria; 33.1% according the DSM-IV) were included in the study. A variety of standardized motor, cognitive, psychiatric, and global severity measures were administered. A multivariate logistic regression model was built to determine the variables producing discrepancy between the MDS-TF and DSM-IV criteria for PDD and the clinical features that distinguished false negative cases. Results Agreement between MDS-TF and DSM-IV criteria was substantial (87.3%; kappa = 0.72), but the DSM-IV criteria failed to identify 22% of patients fulfilling MDS-TF criteria. False negative cases were older and had more severe motor symptoms but less psychosis than those true non-demented PD. False positives had less severe motor symptoms than true PDD, although the difference did not reach statistical significance. Conclusions Our findings suggest that the MDS-TF criteria are more sensitive than the DSM-IV for a diagnosis of PDD. Old age, absence of psychiatric symptoms, and severe motor impairment can hinder the diagnosis of PDD.