Dementia associated with Parkinson’s disease: Applying the Movement Disorder Society Task Force criteria q P. Martinez-Martin a, b, * , C. Falup-Pecurariu c , C. Rodriguez-Blazquez b, d , M. SerranoDueñas e , F.J. Carod Artal f , J.M. Rojo Abuin g , D. Aarsland h a Alzheimer Disease Research Unit, CIEN Foundation, Carlos III Institute of Health, Alzheimer Center Reina Sofia Foundation, Madrid, Spain b Consortium for Biomedical Research in Neurodegenerative Diseases (CIBERNED), CIEN Foundation, Carlos III Institute of Health, Madrid, Spain c Department of Neurology, University Hospital, Faculty of Medicine, Transilvania University, Bras ¸ ov, Romania d National Center of Epidemiology, Carlos III Institute of Health, Madrid, Spain e Movement Disorder and Biostatistic Units, Neurological Service, Carlos Andrade Marín Hospital and Medicine Faculty, Pontifical Catholic University of Ecuador, Quito, Ecuador f Department of Neurology, Virgen de la Luz Hospital, Cuenca, Spain g Statistical Analysis Unit, Human and Social Sciences Center, Spanish Council for Scientific Research, Madrid, Spain h Centre for Age-Related Medicine, Psychiatric Clinic, Stavanger University Hospital, Stavanger, and Karolinska Institutet, Dept NVS, KI Alzheimer Disease Research Center, Novum, SE-141 86 Stockholm, Sweden article info Article history: Received 10 February 2011 Received in revised form 4 April 2011 Accepted 22 May 2011 Keywords: Parkinson’s disease Dementia associated with Parkinson’s disease Criteria Diagnosis Sensitivity abstract Background: Diagnostic criteria and procedures for dementia in Parkinson’s disease (PDD) have been proposed by a Movement Disorders Society Task Force (MDS-TF). The objective of this study was to explore the utility of the new MDS-TF criteria and procedures in clinical practice. Methods: Two hundred ninety nine PD patients (36.5% with PDD as per MDFS-TF criteria; 33.1% according the DSM-IV) were included in the study. A variety of standardized motor, cognitive, psychiatric, and global severity measures were administered. A multivariate logistic regression model was built to determine the variables producing discrepancy between the MDS-TF and DSM-IV criteria for PDD and the clinical features that distinguished false negative cases. Results: Agreement between MDS-TF and DSM-IV criteria was substantial (87.3%; kappa ¼ 0.72), but the DSM-IV criteria failed to identify 22% of patients fulfilling MDS-TF criteria. False negative cases were older and had more severe motor symptoms but less psychosis than those true non-demented PD. False positives had less severe motor symptoms than true PDD, although the difference did not reach statistical significance. Conclusions: Our findings suggest that the MDS-TF criteria are more sensitive than the DSM-IV for a diagnosis of PDD. Old age, absence of psychiatric symptoms, and severe motor impairment can hinder the diagnosis of PDD. Ó 2011 Elsevier Ltd. All rights reserved. 1. Introduction Cognitive impairment is common in Parkinson’s disease (PD) [1,2], with significant implications for PD patients, caregivers and society [3,4]. However, research on cognition in PD has been hampered by the lack of specific and operationalized criteria to diagnose dementia associated with PD (PDD). The widely used DSM-IV criteria subsume PDD under “dementia due to other medical conditions”, and the section specifically devoted to PDD is rather general. The Movement Disorder Society (MDS) therefore recruited a Task Force to define the clinical diagnostic criteria for PDD (MDS-TF criteria) [5]. In addition to the dementia criteria, the MDS-TF also proposed a method to operationalise these criteria, aimed primarily at the clinician with no particular expertise in neuropsychological methods, but who requires a simple, pragmatic set of tests that are not excessively time-consuming, providing a short and simple diagnostic algorithm [6]. The aim was to make practical and unambiguous recommendations, based upon the available litera- ture and the collective experience of the Task Force. q The review of this paper was entirely handled by an Associate Editor, Prof. Eng- King Tan. * Corresponding author. Alzheimer Disease Research Unit, Carlos III Institute of Health, Alzheimer Center Reina Sofia Foundation, C/. Valderrebollo, 5, 28031 Madrid, Spain. Tel.: þ34 918222643; fax: þ34 913877815. E-mail address: pmartinez@isciii.es (P. Martinez-Martin). Contents lists available at ScienceDirect Parkinsonism and Related Disorders journal homepage: www.elsevier.com/locate/parkreldis 1353-8020/$ e see front matter Ó 2011 Elsevier Ltd. All rights reserved. doi:10.1016/j.parkreldis.2011.05.017 Parkinsonism and Related Disorders xxx (2011) 1e4 Please cite this article in press as: Martinez-Martin P, et al., Dementia associated with Parkinson’s disease: Applying the Movement Disorder Society Task Force criteria, Parkinsonism and Related Disorders (2011), doi:10.1016/j.parkreldis.2011.05.017