title: Accuracy of diagnosis in patients with presumed Parkinson's disease.
abstract: OBJECTIVE
  to study the diagnostic accuracy for parkinsonism and Parkinson's disease in a community-based sample of subjects on anti-parkinsonian medication.
  
  
  METHODS
  computerized prescribing records in general practice were used to create a community-based disease register for Parkinson's disease. Subjects were examined to establish the likely diagnosis using recommended clinical diagnostic criteria.
  
  
  RESULTS
  of 402 cases, parkinsonism was confirmed in 74% and clinically probable Parkinson's disease in 53%. The commonest causes of misdiagnosis were essential tremor, Alzheimer's disease and vascular pseudo-parkinsonism. Over one-quarter of subjects did not benefit from anti-parkinsonian medication.
  
  
  CONCLUSIONS
  there is difficulty in diagnosing parkinsonism and Parkinson's disease in elderly subjects and we suggest early referral of those suspected of having parkinsonism for specialist assessment.
authors.affiliation: University Department of Geriatric Medicine, Glan Clwyd Hospital, Rhyl, North Wales, UK.
authors.forename: J
authors.initials: J
authors.lastname: Meara
authors.forename: B K
authors.initials: BK
authors.lastname: Bhowmick
authors.forename: P
authors.initials: P
authors.lastname: Hobson
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D008875:Middle Aged; D010300:Parkinson Disease / Q000175:diagnosis*; D015203:Reproducibility of Results