Department of Geriatrics, Robertsau Hospital, Strasbourg University Hospitals, 83 rue Himmerich, Strasbourg, 67091, France,
J Neurol. 2013 Oct;260(10):2569-79. doi: 10.1007/s00415-013-7018-8. Epub 2013 Jul 9.
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.
本研究旨在评估运动障碍学会（MDS）诊断帕金森病痴呆（PDD）的标准在老年患者中的表现，同时评估在该患者人群中应用其他测试的相关性。MDS 标准包括检查表形式的第一部分简短部分和作为参考基础的第二部分，该部分由深入的神经心理学检查组成。连续纳入 40 名出现认知主诉的 PD 患者。评估 MDS 检查表与 MDS 详尽认知检查的表现，后者被用作参考基础，并与其他认知测试，包括 Mattis 痴呆评定量表（MDRS）、Grober 和 Buschke 测试的法语版、词语流畅性测试、 Rey-Osterreith 复杂图形和听觉连续加法测试进行比较。在总共 40 名 PD 受试者（平均年龄：80.5 ± 4.9 岁）中，根据检查表诊断为 PDD 的有 20 例，根据详尽检查诊断为 PDD 的有 31 例，即后者多诊断出 11 例。检查表诊断 PDD 的敏感性为 0.64，特异性为 1.00。使用 MDRS 诊断 PDD 的截止值为≤120 时，敏感性为 0.80，特异性为 1.00，而截止值为≤132 时，敏感性为 1.00，特异性为 0.444。MDS 检查表对老年 PDD 诊断的特异性得到了证实，但敏感性不足。还发现 MDRS 有助于 PDD 的诊断和筛查。
