Accuracy of diagnosis in patients with presumed Parkinson's disease.
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.
Meara
J
J
University Department of Geriatric Medicine, Glan Clwyd Hospital, Rhyl, North Wales, UK.
Bhowmick
B K
BK
Hobson
P
P
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D008875:Middle Aged; D010300:Parkinson Disease / Q000175:diagnosis*; D015203:Reproducibility of Results