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Pilot study of a three‐step diagnostic pathway for young and old patients with Parkinson's disease dementia: screen, test and then diagnose
Author(s) -
Robben Sarah H. M.,
Sleegers Monique J. M.,
Dautzenberg Paul L. J.,
van Bergen Floor S.,
ter Bruggen JanPieter,
Rikkert Marcel G. M. Olde
Publication year - 2010
Publication title -
international journal of geriatric psychiatry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.28
H-Index - 129
eISSN - 1099-1166
pISSN - 0885-6230
DOI - 10.1002/gps.2331
Subject(s) - montreal cognitive assessment , dementia , medicine , parkinson's disease , neuropsychology , prospective cohort study , neuropsychological test , cognitive impairment , pediatrics , physical therapy , disease , psychiatry , cognition
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, ≤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. Copyright © 2009 John Wiley & Sons, Ltd.