September 2011
Martinez-Martin P, Falup-Pecurariu C,
Rodriguez-Blazquez C, Serranodueñas M, Carod Artal FJ, Rojo
Abuin JM,
Aarsland D
Background: Diagnostic
criteria and procedures for dementia in Parkinson’s disease (PDD) have
been proposed by a Movement Disorders Society Task Force (MDS-TF). The
objective of this study was to explore the utility of the new MDS-TF
criteria and procedures in clinical practice.
Methods: Two
hundred ninety nine PD patients (36.5% with PDD as per MDFS-TF
criteria; 33.1% according the DSM-IV) were included in the study. A
variety of standardized motor, cognitive, psychiatric, and global
severity measures were administered. A multivariate logistic regression
model was built to determine the variables producing discrepancy between
the MDS-TF and DSM-IV criteria for PDD and the clinical features that
distinguished false negative cases.
Results: Agreement
between MDS-TF and DSM-IV criteria was substantial (87.3%;
kappa = 0.72), but the DSM-IV criteria failed to identify 22% of
patients fulfilling MDS-TF criteria. False negative cases were older and
had more severe motor symptoms but less psychosis than those true
non-demented PD. False positives had less severe motor symptoms than
true PDD, although the difference did not reach statistical
significance.
Conclusions: Our
findings suggest that the MDS-TF criteria are more sensitive than the
DSM-IV for a diagnosis of PDD. Old age, absence of psychiatric symptoms,
and severe motor impairment can hinder the diagnosis of PDD.
