• Josephine B M Christ, Monika Fruhmann Berger, Ellen Riedl, Deborah Prakash, Ilona Csoti, Wolfgang Molt, Susanne Gräber, Kathrin Brockmann, Daniela Berg, and Inga Liepelt-Scarfone.
• Hertie Institute for Clinical Brain Research, Department of Neurodegeneration, University of Tuebingen, Germany.
• Parkinsonism Relat. Disord. 2013 Mar 1;19(3):371-4.

BackgroundBeside the presence of cognitive deficits, impaired activities of daily living (ADL) are crucial for the diagnosis of dementia in Parkinson's disease (PD). Several scales can be used to evaluate PD patients' ADL (dys)function. However, only a few of them sufficiently discriminate between demented and non-demented PD patients. It is well-known that the diagnostic accuracy of ADL scales for Parkinson's disease dementia (PDD) is influenced by confounding variables such as motor worsening.ObjectiveTo evaluate the diagnostic accuracy of ADL scales for PDD.MethodsIn a cohort of 106 patients (21 with dementia), we evaluated observer-based activities of daily living rating scales (e.g. Pill Questionnaire, Schwab & England Scale), caregiver assessments, and patient questionnaires (e.g. Lawton Instrumental Activities of Daily Living Scale).ResultsEach inventory showed moderate or even high specificity for dementia (>75.3%). Sensitivity was highest for the Pill Questionnaire (90.5%). Interestingly, the ratings of caregivers and trained clinical observers overestimated the presence of dementia.ConclusionsStandardized activities of daily living assessments like the Pill Questionnaire accompanied by neuropsychological testing can be a helpful tool for the diagnosis of PDD. Further studies are needed to verify these first results in larger cohorts.Copyright © 2012 Elsevier Ltd. All rights reserved.

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