August 2011
Hu M, Cooper J,
Beamish R, Jones E, Butterworth R, Catterall L, Ben-Shlomo Y
Although
awareness of non-motor symptoms in Parkinson's disease (PD) has recently
increased, little is known about their recognition and treatment in routine
clinical practice. We therefore applied non-motor rating scales for dementia,
depression, anxiety and excessive daytime sleepiness to a community-ascertained
cohort of 202 PD patients.
Hospital case notes were reviewed for evidence that
the non-motor problems had been recognized and whether any action had been
taken to ameliorate or assess these symptoms.
The prevalence of each non-motor
problem was as follows: dementia 25.3% (95% CI 19.0, 32.4), depression 37.3%
(95% CI 30.6, 44.4), anxiety 31.3% (95% CI 25.0, 38.2), excessive daytime
sleepiness 59.4% (95% CI 52.2, 66.3). However, these features were only
recognised in 27.2, 38.7, 9.5, and 12.8%, respectively. We did not identify any
specific factor that predicted under-recognition.
Our study shows that when
rating scales are applied to formally assess for non-motor symptoms a large
clinical 'iceberg effect' emerges with the majority of symptoms going
unrecognised and untreated.
