[Diagnosis and treatment of patients with parkinsonism in nursing homes: how to improve quality?].

BACKGROUND

Studies have shown that diagnosing and treating patients with parkinsonism in nursing homes could be improved. Parkinson's disease is the most important cause of parkinsonism.

MATERIALS AND METHODS

The data for this article have been obtained through a literature search and by research in our own centre.

RESULTS AND INTERPRETATION

Parkinsonism is a frequent cause of functional impairment among the elderly. The diagnosis is based on an evaluation of the four cardinal signs of parkinsonism (resting tremor, akinesia, rigidity, and postural abnormalities). Parkinsonism may be caused by Parkinson's disease, symptomatic parkinsonism, pseudoparkinsonism or be a part of the presentation of other neurodegenerative diseases. A systematic examination for suspected parkinsonism followed by an evaluation of causes of parkinsonism will improve the diagnostic quality in nursing homes. Patients with Parkinson's disease have motor as well as non-motor problems, hence management should focus on all aspects of the symptoms experienced by these patients, not only the motor symptoms. Several investigations have shown that non-motor problems may detract more from the quality of life than the motor symptoms. 5% of all residents in nursing homes in Norway have Parkinson's disease; 20% of them are unrecognised by the medical staff. Intervention in nursing homes from physicians with more knowledge on parkinsonism has been shown to improve diagnostic accuracy as well as management.