The Movement Disorders Society criteria for the diagnosis of Parkinson’s disease dementia: their usefulness and limitations in elderly patients

Abstract

The aim of this study was to assess the performance of the Movement Disorders Society (MDS) criteria for the diagnosis of Parkinson's disease dementia (PDD) in the elderly, and also to evaluate the relevance of applying other tests in this patient population. The MDS criteria include a first short part in checklist form, and a second part which is used as a basis for reference and consists of an in-depth neuropsychological examination. Forty consecutive PD patients presenting with cognitive complaints were enrolled. An assessment was made of the performances of the MDS checklist compared with the MDS exhaustive cognitive examination which was used as a basis for reference, and with other cognitive tests including the Mattis Dementia Rating Scale (MDRS), the French version of the Grober and Buschke test, the verbal fluency test, the Rey-Osterreith complex figure and the paced auditory serial addition test. Out of a total of 40 PD subjects (mean age: 80.5 ± 4.9 years), 20 were diagnosed with PDD according to the checklist and 31 on the basis of the exhaustive examination, i.e. with 11 more patients diagnosed via the latter. The sensitivity of the checklist for the diagnosis of PDD was 0.64, with a specificity of 1.00. The use of the MDRS for PDD diagnosis with a cut-off at ≤ 120 showed a sensitivity of 0.80 and a specificity of 1.00, while at ≤ 132 it displayed a sensitivity of 1.00 and a specificity of 0.444. The specificity of the checklist for the diagnosis of PDD in the elderly was confirmed, but it was lacking in sensitivity. It was also found that the MDRS could be helpful in the diagnosis and screening of PDD.

Comparison of the Movement Disorder Society Parkinson's disease dementia criteria with neuropsychological testing

“…This study expands the results for validation efforts of the MDS Task Force diagnostic procedures for Level I and Level II criteria for PDD. Our study findings add to the efforts of other centers to validate these potentially useful criteria Given that the conventional approach to defining dementia in PD incorporates traditional neuropsychological testing, with its associated variability in test selection and often time‐consuming assessments, the MDS Task Force efforts have focused on ways to standardize testing that can be used across multiple centers and to identify time‐efficient methods to diagnose PDD.…”

Validation of Neuropsychological Tests to Screen for Dementia in Chinese Patients With Parkinson’s Disease

“…This incidence was comparable to that found in some studies 35,36 but was inconsistent with that reported in some other studies. 32,[37][38][39] To our expectations, all the examined dementia scales (MMSE, MoCA, BD, RVR, DS, and FOME) demonstrated significant differences between patients with PDD and PDND. In ROC curve analysis, MMSE, MoCA, and BD showed better specificity and sensitivity when used alone.…”

Effect of Cognitive Disability and Ambulation Status on Functioning in Moderate-to-Advanced Parkinson Disease

“…As a cross-sectional study, the limitations of this study include its sampling population, which consists of moderate to advanced PwP, restricting the applicability of the aforementioned findings to people with early stage or mild disease and precludes inferences about causality. Secondly, due to the retrospective nature of the study, the group with cognition disability was defined using the more generic cognition domain score on the FUNDES-Adult instead of tests such as the Mini Mental State exam or the Montreal Cognitive Assessment and definitions of the Movement Disorder Society criteria for PDD (39); cognition while those in this group may not strictly fulfill the diagnosis of "dementia" and may even include those with non-demented cognitive impairment, this method may have wider applicability in the primary care setting, providing an easier assessment of cognitive status for Physical Medicine and Rehabilitation physicians, physical therapists, or clinicians less familiar PDD diagnosis or when formal comprehensive neuropsychological testing cannot be conducted. Similarly, ambulation and walking status was evaluated by asking the patient to walk back and fro 3 m (domain 8.6 of FUNDES-Adult) instead of tests such as the Timed up and Go test.…”