How well do we recognise non-motor symptoms in a British Parkinson’s disease population?
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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.
- How well do we recognise non-motor symptoms in a British Parkinson’s disease population?
Journal of Neurology
Volume 258, Issue 8 , pp 1513-1517
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- Parkinson’s disease
- Non-motor symptoms
- Industry Sectors
- Author Affiliations
- 1. Department of Neurology, Milton Keynes Hospital NHS Foundation Trust and Oxford Radcliffe Hospitals, Oxford, UK
- 6. Department of Clinical Neurology, Level 3, West Wing, John Radcliffe Hospital, Headley Way, Oxford, OX3 9DU, UK
- 2. Department of General Medicine, Milton Keynes Hospital NHS Foundation Trust, Milton Keynes, UK
- 3. Milton Keynes Neuro-Rehabilitation Unit, Milton Keynes, UK
- 4. Thames Valley Dementia and Neurodegenerative Diseases Research Network (DeNDRoN), Oxford, UK
- 5. Department of Social Medicine, University of Bristol, Bristol, UK