• J. Neurol. Neurosurg. Psychiatr. · Sep 2014

    Comparative Study

    Comparison of activities of daily living impairments in Parkinson's disease patients as defined by the Pill Questionnaire and assessments by neurologists.

    • Wei-Ju Lee, Yung-Yee Chang, Juei-Jueng Lin, Yueh-Feng Sung, Jie-Yuan Li, Shuu-Jiun Wang, Rou-Shayn Chen, Yuan-Han Yang, Chaur-Jong Hu, Chon-Haw Tsai, Han-Cheng Wang, Shey-Lin Wu, Ming-Hong Chang, and Jong-Ling Fuh.
    • Department of Neurology, Taichung Veterans General Hospital, Taichung, Taiwan Faculty of Medicine, National Yang-Ming University Schools of Medicine, Taipei, Taiwan Institute of Clinical Medicine, National Yang-Ming University Schools of Medicine, Taipei, Taiwan.
    • J. Neurol. Neurosurg. Psychiatr.. 2014 Sep 1;85(9):969-73.

    ObjectivesTo compare the clinical judgment of experienced neurologists after interviewing Parkinson's disease (PD) patients and their caregivers with the use of the Pill Questionnaire to determine the presence of impairments on activities of daily living (ADL).BackgroundADL impairment is a criterion for the diagnosis of dementia associated with PD. The Pill Questionnaire has been recommended as a screening tool to assess ADL impairment in PD patients, but its usefulness and validity have not been fully investigated.MethodsWe recruited idiopathic PD patients from 12 hospitals in Taiwan, and the patients underwent clinical assessments, a neuropsychological test battery and the Unified Parkinson Disease Rating Scale evaluation. The Pill Questionnaire was administered by study assistants. Patient and caregiver interviews were performed by experienced neurologists who were blinded to the Pill Questionnaire results.ResultsIn total, 284 PD patients (mean age 71.8±9 years, mean education 8.7±5.3 years, mean disease duration 5.4±5.3 years) were recruited. 63 patients showed ADL impairment by the Pill Questionnaire, and 108 patients showed ADL impairment by neurologists' clinical interviews. κ Statistics showed moderate agreement between the two methods (κ=0.521, p<0.001). Of the 108 patients who were diagnosed with ADL impairment by neurologists, only 56 patients (51.9%) showed impairment according to the Pill Questionnaire. Most of the missed patients had milder cognitive impairment and lower motor disability.ConclusionsA comprehensive interview is essential to determine the presence of ADL impairment in PD patients, especially in patients with early PD.Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

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