title: Clinical validation of Movement Disorder Society-recommended diagnostic criteria for Parkinson's disease with dementia.
abstract: The objective of this work was to evaluate the Movement Disorders Society (MDS) Task Force-proposed screening checklist for detecting Parkinson's disease dementia (PD-D) in relation to full neuropsychological testing. An MDS Task Force has proposed diagnostic procedures for PD-D, which have not been fully validated against more extensive neuropsychological testing. PD subjects were recruited from 2 specialty centers. A neuropsychologist evaluated them for dementia as part of routine clinical care. Independent clinical neurologists administered the MDS PD-D screening checklist. Diagnosis of PD-D by the 2 methods was compared. Ninety-one PD subjects had a mean age of 66.3 (SD = 9.7) years and a mean PD duration of 8.8 (SD = 6.1) years. Seven subjects (7.7%) met all 8 screening checklist criteria from the MDS PD-D screening tool and were classified as probable PD-D. Fifteen (16.5%) subjects were classified as PD-D by full neuropsychological assessment. The screening checklist showed 100% specificity, but only 46.7% sensitivity, for diagnosing PD-D compared to the full neuropsychological assessment. PD-D cases missed by the PD-D screening tool were largely due to 2 checklist items that were not endorsed (absence of depression and Mini-Mental State Examination [MMSE] scores <26). There was moderate agreement between these 2 methods for determination of PD-D (kappa = 0.59, P < .001). The MDS-PD-D screening checklist is highly accurate for detecting PD-D if all items are endorsed. However, for cases that do not meet these criteria, full neuropsychological testing is needed to differentiate PD-D from milder cognitive impairment. Revision of the checklist by altering or eliminating the 2 problematic checklist items may improve sensitivity.
authors.affiliation: Department of Neurological Sciences, Section of Parkinson Disease and Movement Disorders, Rush University Medical Center, Chicago, Illinois 60612, USA.
authors.forename: Brandon
authors.initials: B
authors.lastname: Barton
authors.forename: David
authors.initials: D
authors.lastname: Grabli
authors.forename: Bryan
authors.initials: B
authors.lastname: Bernard
authors.forename: Virginie
authors.initials: V
authors.lastname: Czernecki
authors.forename: Jennifer G
authors.initials: JG
authors.lastname: Goldman
authors.forename: Glenn
authors.initials: G
authors.lastname: Stebbins
authors.forename: Bruno
authors.initials: B
authors.lastname: Dubois
authors.forename: Christopher G
authors.initials: CG
authors.lastname: Goetz
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D057189:Checklist; D016009:Chi-Square Distribution; D003072:Cognition Disorders / Q000175:diagnosis / Q000209:etiology; D003704:Dementia / Q000150:complications*; D005260:Female; D006801:Humans; D008297:Male; D008568:Memory / Q000502:physiology; D008875:Middle Aged; D009483:Neuropsychological Tests / Q000592:standards*; D010300:Parkinson Disease / Q000150:complications / Q000175:diagnosis / Q000523:psychology; D011569:Psychiatric Status Rating Scales / Q000592:standards*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity