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

J Neurol. 2011 Aug;258(8):1513-7. doi: 10.1007/s00415-011-5972-6. Epub 2011 Mar 11.

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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Anxiety / epidemiology*
  • Anxiety / etiology
  • Child
  • Dementia / epidemiology*
  • Dementia / etiology
  • Depression / epidemiology*
  • Depression / etiology
  • Humans
  • Infant
  • Middle Aged
  • Neuropsychological Tests
  • Parkinson Disease / complications*
  • Parkinson Disease / diagnosis
  • Parkinson Disease / psychology
  • Prevalence
  • Sleep Wake Disorders / epidemiology*
  • Sleep Wake Disorders / etiology
  • United Kingdom