Clinical diagnostic criteria for dementia associated with Parkinson's disease.
Dementia has been increasingly more recognized to be a common feature in patients with Parkinson's disease (PD), especially in old age. Specific criteria for the clinical diagnosis of dementia associated with PD (PD-D), however, have been lacking. A Task Force, organized by the Movement Disorder Study, was charged with the development of clinical diagnostic criteria for PD-D. The Task Force members were assigned to sub-committees and performed a systematic review of the literature, based on pre-defined selection criteria, in order to identify the epidemiological, clinical, auxillary, and pathological features of PD-D. Clinical diagnostic criteria were then developed based on these findings and group consensus. The incidence of dementia in PD is increased up to six times, point-prevelance is close to 30%, older age and akinetic-rigid form are associated with higher risk. PD-D is characterized by impairment in attention, memory, executive and visuo-spatial functions, behavioral symptoms such as affective changes, hallucinations, and apathy are frequent. There are no specific ancillary investigations for the diagnosis; the main pathological correlate is Lewy body-type degeneration in cerebral cortex and limbic structures. Based on the characteristic features associated with this condition, clinical diagnostic criteria for probable and possible PD-D are proposed.
Emre
Murat
M
Department of Neurology, Behavioral Neurology and Movement Disorders Unit, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey. muratemre@superonline.com
Aarsland
Dag
D
Brown
Richard
R
Burn
David J
DJ
Duyckaerts
Charles
C
Mizuno
Yoshikino
Y
Broe
Gerald Anthony
GA
Cummings
Jeffrey
J
Dickson
Dennis W
DW
Gauthier
Serge
S
Goldman
Jennifer
J
Goetz
Christopher
C
Korczyn
Amos
A
Lees
Andrew
A
Levy
Richard
R
Litvan
Irene
I
McKeith
Ian
I
Olanow
Warren
W
Poewe
Werner
W
Quinn
Niall
N
Sampaio
Christina
C
Tolosa
Eduardo
E
Dubois
Bruno
B
D003704:Dementia / Q000150:complications* / Q000175:diagnosis* / Q000453:epidemiology; D003937:Diagnosis, Differential; D006801:Humans; D009483:Neuropsychological Tests / Q000592:standards / Q000706:statistics & numerical data; D010300:Parkinson Disease / Q000150:complications* / Q000175:diagnosis* / Q000453:epidemiology; D012720:Severity of Illness Index; D013647:Task Performance and Analysis