Pilot study of a three-step diagnostic pathway for young and old patients with Parkinson's disease dementia: screen, test and then diagnose.

Abstract:

OBJECTIVE:To pilot a three-step diagnostic model for young and old patients with Parkinson's disease dementia (PDD). METHODS:Prospective investigator-blinded study. We developed a screening questionnaire for patients with Parkinson's disease (PD) and their caregivers. Further, patients were subjected to three screening instruments (Montreal Cognitive Assessment (MoCA), Frontal Assessment Battery (FAB), Addenbrooke's Cognitive Examination-revised (ACE-R) and a detailed neuropsychological examination (NPE). Based on the NPE, patients were divided in a PD (without dementia) and a PDD-group. RESULTS:Forty-one PD patients, aged 37-94 years, participated in this study. Patients were divided in a young group, < or = 65 (n = 22) and an old group >65 years (n = 19). In the young group (PDD, n = 5) the patient-screening questionnaire predicted PDD with a sensitivity/specificity of 100.0%/94.1%; in the old group (PDD, n = 10) the proxy-screening questionnaire predicted PDD with a sensitivity/specificity of 88.9%/66.7%. In the young group, ACE-R had the largest Area Under the Curve (AUC) 0.88 (0.70-1.00), in the old group MoCA (AUC 1.00). However, the three instruments did not differ significantly. CONCLUSIONS:It seems feasible and efficient to use three consecutive diagnostic steps for PDD: (1) a screening questionnaire, (2) if positive: MoCA, FAB or ACE-R as screening instrument and (3) if positive: a detailed NPE for diagnosing PDD.

authors

Robben SH,Sleegers MJ,Dautzenberg PL,van Bergen FS,ter Bruggen JP,Rikkert MG

doi

10.1002/gps.2331

subject

Has Abstract

pub_date

2010-03-01 00:00:00

pages

258-65

issue

3

eissn

0885-6230

issn

1099-1166

journal_volume

25

pub_type

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