title: A simplified algorithm may lead to overestimate dementia in PD. A clinical and epidemiological study using criteria for PD-D proposed by the Movement Disorders Task Force.
abstract: Making an accurate diagnosis of dementia in Parkinson's disease (PD-D) patients is a challenge that neurologists will have to face in the coming years. In 2007, a Task force of the Movement Disorders Society proposed operational diagnostic criteria for the diagnosis of PD-D, consisting of step I and step II. We assessed the validity of step I with reference to the diagnosis made after a formal neuropsychological evaluation and by applying the current gold standard for the diagnosis of PD-D (DSM IV). Step I had a sensitivity of 78% and a specificity of 95.5%. Step I displayed a positive predictive value of 70%, a negative predictive value of 97%, and an accuracy of 93.4%. The clinimetric properties observed in our setting suggest that step I may be considered as a good screening tool (negative predictive value of 97%); however, using step I alone to make a diagnosis of PD-D may lead to an overestimation of dementia in PD, particularly in patients with considerable dysexecutive deficits (positive predictive value of 70%). In conclusion, formal neuropsychology and longitudinal follow-up are still required for the diagnosis and categorization of dementia in PD.
authors.affiliation: Centro Parkinson D.A.I. Neurologia e Pischiatria Policlinico Universitario Umberto I, Sapienza Università di Roma, Viale dell'Università 30, Rome, Italy.
authors.forename: M E
authors.initials: ME
authors.lastname: Di Battista
authors.forename: P
authors.initials: P
authors.lastname: Giustini
authors.forename: S
authors.initials: S
authors.lastname: Bernardi
authors.forename: P
authors.initials: P
authors.lastname: Stirpe
authors.forename: N
authors.initials: N
authors.lastname: Vanacore
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Meco
mesh_terms: D026683:Advisory Committees / Q000592:standards*; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D015897:Comorbidity / Q000639:trends; D003704:Dementia / Q000175:diagnosis* / Q000453:epidemiology*; D003951:Diagnostic Errors / Q000517:prevention & control; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests / Q000592:standards*; D010300:Parkinson Disease / Q000453:epidemiology*; D017410:Practice Guidelines as Topic / Q000592:standards