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 Applying the diagnostic criteria for PDD 
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Joined: Fri Aug 11, 2006 1:46 pm
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Post Applying the diagnostic criteria for PDD
While there are consensus criteria for diagnosing DLB (dementia with Lewy bodies) clinically, there is not yet any consensus criteria for PDD (Parkinson's disease dementia). Probably all of you are familiar with the one-year rule. PDD is the diagnosis if the dementia process started at least one year after onset of PD. If the dementia process started before the onset of PD or within the first year of PD onset, then the diagnosis is DLB.

In 2007 the Movement Disorder Society Task Force proposed some diagnostic criteria for PDD. Since then, it's been up to researchers to evaluate and validate the criteria in the real world. This paper out of Spain is one such attempt.

The researchers looked at nearly 300 PD patients and diagnosed 36.5% with PDD using the MDS-TF criteria. Using the DSM-IV, which has criteria for diagnosing someone with dementia, 33.1% of the nearly 300 patients were diagnosed with PD dementia.

The authors state: 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."

Hopefully I've got this right: false negative cases are those for which the DSM-IV criteria said that the person was NOT demented but according to the MDS-TF the person WAS demented. And false positives are those for which the DSM-IV criteria said that the person WAS demented but according to the MDS-TF the person was NOT demented.

The authors conclude: "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."

If you want to read the MDS-TF diagnostic criteria for PDD, go to PubMed (pubmed.gov) and search for PubMed ID# 18098298. You'll find a link to the article on the Movement Disorder Society's website at no charge.

I've copied the abstract below.

Robin



Parkinsonism & Related Disorders. 2011 Jun 29. [Epub ahead of print]

Dementia associated with Parkinson's disease: Applying the Movement Disorder Society Task Force criteria.

Martinez-Martin P, Falup-Pecurariu C, Rodriguez-Blazquez C, Serrano-Dueñas M, Carod Artal FJ, Rojo Abuin JM, Aarsland D.
Alzheimer Disease Research Unit, CIEN Foundation, Carlos III Institute of Health, Alzheimer Center Reina Sofia Foundation, Madrid, Spain; Consortium for Biomedical Research in Neurodegenerative Diseases (CIBERNED), CIEN Foundation, Carlos III Institute of Health, Madrid, Spain.

Abstract

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.

Copyright © 2011 Elsevier Ltd. All rights reserved.

PubMed ID#: 21684792 (see pubmed.gov for this abstract only)


Tue Jul 19, 2011 1:01 am
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