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How well do we recognise non-motor symptoms in a British Parkinson’s disease population?

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Abstract

Although awareness of non-motor symptoms in Parkinson’s disease (PD) has recently increased, little is known about their recognition and treatment in routine clinical practice. We therefore applied non-motor rating scales for dementia, depression, anxiety and excessive daytime sleepiness to a community-ascertained cohort of 202 PD patients. Hospital case notes were reviewed for evidence that the non-motor problems had been recognized and whether any action had been taken to ameliorate or assess these symptoms. The prevalence of each non-motor problem was as follows: dementia 25.3% (95% CI 19.0, 32.4), depression 37.3% (95% CI 30.6, 44.4), anxiety 31.3% (95% CI 25.0, 38.2), excessive daytime sleepiness 59.4% (95% CI 52.2, 66.3). However, these features were only recognised in 27.2, 38.7, 9.5, and 12.8%, respectively. We did not identify any specific factor that predicted under-recognition. Our study shows that when rating scales are applied to formally assess for non-motor symptoms a large clinical ‘iceberg effect’ emerges with the majority of symptoms going unrecognised and untreated.

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Acknowledgments

We are grateful to our patients and their carers for generously giving their time to take part in this research. This study was funded by a Parkinson’s UK grant with nursing support provided by Thames Valley Dementia and Neurodegenerative Diseases Research Network (DeNDRoN). MH received funding from the National Institute for Health Research (NIHR) and the Oxford Biomedical Research Centre (BRC) in support of research time incurred for this study.

Conflict of interest

Authors have no conflict of interest to declare.

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Authors and Affiliations

  1. Department of Neurology, Milton Keynes Hospital NHS Foundation Trust and Oxford Radcliffe Hospitals, Oxford, UK

    Michele Hu & Richard Butterworth

  2. Department of General Medicine, Milton Keynes Hospital NHS Foundation Trust, Milton Keynes, UK

    Jonathan Cooper & Rebecca Beamish

  3. Milton Keynes Neuro-Rehabilitation Unit, Milton Keynes, UK

    Emma Jones

  4. Thames Valley Dementia and Neurodegenerative Diseases Research Network (DeNDRoN), Oxford, UK

    Lesley Catterall

  5. Department of Social Medicine, University of Bristol, Bristol, UK

    Yoav Ben-Shlomo

  6. Department of Clinical Neurology, Level 3, West Wing, John Radcliffe Hospital, Headley Way, Oxford, OX3 9DU, UK

    Michele Hu

Authors
  1. Michele Hu
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  2. Jonathan Cooper
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  3. Rebecca Beamish
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  4. Emma Jones
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  5. Richard Butterworth
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  7. Yoav Ben-Shlomo
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Correspondence to Michele Hu.

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Hu, M., Cooper, J., Beamish, R. et al. How well do we recognise non-motor symptoms in a British Parkinson’s disease population?. J Neurol 258, 1513–1517 (2011). https://doi.org/10.1007/s00415-011-5972-6

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  • DOI: https://doi.org/10.1007/s00415-011-5972-6

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