Emre et al listed criteria for the diagnosis of dementia associated with Parkinson's disease. The authors are from multiple institutions from around the world.
Parameters:
(1) core features
(2) associated clinical features - cognitive
(3) associated clinical features - behavioral
(4) features making the diagnosis uncertain
(5) features making the diagnosis doubtful or difficult
Core features:
(1) diagnosis of Parkinson's disease
(2) dementia of slow progression within the setting of Parkinson's disease with all of the following:
(2a) impairment in 2 or more cognitive domains
(2b) decline from premorbid level
(2c) impairment in activities of daily living
|
Cognitive Feature |
Typical |
Atypical |
|
attention |
difficulty with attention tasks; may fluctuate from day to day and during the day |
|
|
executive functions |
difficulty initiating, planning, forming concepts, rule finding, set shifting, mental speed |
|
|
visuo-spatial functions |
difficulty with tasks requiring visual and/or spatial orientation, perception or construction |
|
|
memory |
poor recall for recent events, new material, improves with cueing, recognition better than free recall |
does not improve with cueing or in recognition |
|
language |
preserved but may have difficulty with word finding or understanding complex sentences |
prominent or fluent aphasia |
Behavioral features:
(1) apathy
(2) change in mood and/or personality
(3) hallucinations (often visual)
(4) delusions (often of the paranoid type)
(5) excessive daytime sleepiness
Features making the diagnosis uncertain:
(1) presence of another disease that can explain the cognitive difficulties
(2) time interval between development of motor and cognitive symptoms unknown (with dementia in Parkinson's disease the motor problems should appear before the cognitive decline)
Features making the diagnosis doubtful or difficult
(1) vascular disease sufficient to cause vascular dementia
(2) acute confusion due to drug intoxication, systemic disease, etc
(3) major depression
|
Parameter |
Probable Dementia-PD |
Possible Dementia-PD |
|
core features |
both |
both |
|
cognitive features |
>= 2 typical |
present; may be typical or atypical |
|
behavioral features |
>= 1 supports, absence does not exclude |
NA |
|
features making uncertain |
none |
1 or more |
|
features for doubtful or difficult diagnosis |
none |
none |
Specialty: Neurology
