Pilot study of a three‐step diagnostic pathway for young and old patients with Parkinson's disease dementia: screen, test and then diagnose
Identifieur interne : 002571 ( Main/Curation ); précédent : 002570; suivant : 002572Pilot study of a three‐step diagnostic pathway for young and old patients with Parkinson's disease dementia: screen, test and then diagnose
Auteurs : Sarah H. M. Robben [Pays-Bas] ; Monique J. M. Sleegers [Pays-Bas] ; Paul L. J. Dautzenberg [Pays-Bas] ; Floor S. Van Bergen [Pays-Bas] ; Jan-Pieter Ter Bruggen [Pays-Bas] ; Marcel G. M. Olde Rikkert [Pays-Bas]Source :
- International Journal of Geriatric Psychiatry [ 0885-6230 ] ; 2010-03.
English descriptors
Abstract
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.
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DOI: 10.1002/gps.2331
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Psychiatry</title><idno type="ISSN">0885-6230</idno><idno type="eISSN">1099-1166</idno><imprint><publisher>John Wiley & Sons, Ltd.</publisher><pubPlace>Chichester, UK</pubPlace><date type="published" when="2010-03">2010-03</date><biblScope unit="volume">25</biblScope><biblScope unit="issue">3</biblScope><biblScope unit="page" from="258">258</biblScope><biblScope unit="page" to="265">265</biblScope></imprint><idno type="ISSN">0885-6230</idno></series><idno type="istex">A69B6145B5F13DE196DE97FE9AA078BFDE03A8A8</idno><idno type="DOI">10.1002/gps.2331</idno><idno type="ArticleID">GPS2331</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0885-6230</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Parkinson's disease</term><term>cognition</term><term>dementia</term><term>neuropsychology</term><term>screening tests</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">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.</div></front></TEI></record>Pour manipuler ce document sous Unix (Dilib)
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