Movement Disorders Unit, Neurology Department, Sant Pau Hospital, Autonomous University of Barcelona, Barcelona, Spain.
Mov Disord. 2010 Mar 15;25(4):440-6. doi: 10.1002/mds.22877.
The diagnosis of Parkinson's disease with dementia (PDD) is currently based on clinical criteria (DSM-IV, MDS-Task Force). In daily practice and research studies, these criteria still depend on the subjective impression of the examiner. Brief screening tests (BST) are helpful in identifying patients with PD with dementia, which can be difficult in patients with advanced PD. We aimed to develop a BST for PD, the PDD-Short Screen (PDD-SS), to accurately and quickly screen for PDD. In this prospective study, 70 patients with nondemented (age 73.8 +/- 4.4) and 32 demented (age 73.8 +/- 4.4) PD regularly attending a Movement Disorders Clinic were included. Diagnosis of dementia was based on DSM-IV criteria, CDR score >or=1, and PD-CRS total score <or=64. The PDD-SS, Mattis Dementia Rating Scale (MDRS), and Mini-Mental State Examination (MMSE) were administered to all participants. Validity, reliability, and discriminative power of the PDD-SS were examined. The final version of the scale included the items immediate and delayed verbal memory, clock drawing, alternating verbal fluency, and a questionnaire covering cognitive and psychiatric (hallucinations, apathy) symptoms common in PDD. A cutoff score <or=11 on the PDD-SS yielded high sensitivity (89.8%) and specificity (88.5%) for diagnosing PDD. The MDRS displayed similar accuracy, but the PDD-SS administration time was significantly shorter (4.8-6.9 vs. 17.5-25.2 minutes). Diagnosis of dementia using the PDD-SS was not influenced by age, education, or motor function. The PDD-SS appears as the first BST for diagnosing PDD, displays an excellent diagnostic accuracy, and takes 5 to 7 minutes to be administered.
帕金森病伴痴呆（PDD）的诊断目前基于临床标准（DSM-IV、MDS-工作组）。在日常实践和研究中，这些标准仍然依赖于检查者的主观印象。简短的筛查测试（BST）有助于识别患有痴呆的 PD 患者，但在晚期 PD 患者中可能会很困难。我们旨在开发一种用于 PD 的 BST，即 PDD-Short Screen（PDD-SS），以便快速准确地筛查 PDD。在这项前瞻性研究中，纳入了 70 名非痴呆（年龄 73.8 +/- 4.4）和 32 名痴呆（年龄 73.8 +/- 4.4）的定期就诊于运动障碍诊所的 PD 患者。痴呆的诊断基于 DSM-IV 标准、CDR 评分≥1 和 PD-CRS 总分<64。对所有参与者进行了 PDD-SS、Mattis 痴呆评定量表（MDRS）和简易精神状态检查（MMSE）。检查了 PDD-SS 的有效性、可靠性和区分能力。该量表的最终版本包括即时和延迟言语记忆、画钟、交替言语流畅性以及涵盖常见于 PDD 的认知和精神症状（幻觉、冷漠）的问卷。PDD-SS 的截断值<11 对诊断 PDD 具有很高的敏感性（89.8%）和特异性（88.5%）。MDRS 显示出类似的准确性，但 PDD-SS 的给药时间明显更短（4.8-6.9 分钟对 17.5-25.2 分钟）。使用 PDD-SS 诊断痴呆不受年龄、教育程度或运动功能的影响。PDD-SS 似乎是第一个用于诊断 PDD 的 BST，具有出色的诊断准确性，给药时间为 5 到 7 分钟。
