The nondeclaration of nonmotor symptoms of Parkinson's disease to health care professionals: An international study using the nonmotor symptoms questionnaire (original) (raw)
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How well do we recognise non-motor symptoms in a British Parkinson’s disease population?
Journal of Neurology, 2011
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.
Movement Disorders, 2006
Nonmotor symptoms (NMS) of Parkinson's disease (PD) are not well recognized in clinical practice, either in primary or in secondary care, and are frequently missed during routine consultations. There is no single instrument (questionnaire or scale) that enables a comprehensive assessment of the range of NMS in PD both for the identification of problems and for the measurement of outcome. Against this background, a multidisciplinary group of experts, including patient group representatives, has developed an NMS screening questionnaire comprising 30 items. This instrument does not provide an overall score of disability and is not a graded or rating instrument. Instead, it is a screening tool designed to draw attention to the presence of NMS and initiate further investigation. In this article, we present the results from an international pilot study assessing feasibility, validity, and acceptability of a nonmotor questionnaire (NMSQuest). Data from 123 PD patients and 96 controls were analyzed. NMS were highly significantly more prevalent in PD compared to controls (PD NMS, median = 9.0, mean = 9.5 vs. control NMS, median = 5.5, mean = 4.0; Mann–Whitney, Kruskal–Wallis, and t test, P < 0.0001), with PD patients reporting at least 10 different NMS on average per patient. In PD, NMS were highly significantly more prevalent across all disease stages and the number of symptoms correlated significantly with advancing disease and duration of disease. Furthermore, frequently, problems such as diplopia, dribbling, apathy, blues, taste and smell problems were never previously disclosed to the health professionals. © 2006 Movement Disorder Society
Prevalence of Non-Motor Symptoms in Parkinson's Disease – an Observational Study
Romanian Journal of Neurology, 2014
Objectives. This study aim is to evaluate the prevalence of non-motor symptoms in Parkinson's disease Methodology. We conducted an observational study in a prospective approach on a cohort of 70 patients admitted with a diagnosis of Parkinson's disease in the Neurology Department of the University Emergency Hospital Bucharest for pre-surgery assessment or reffered for a consultation to the Outpatient Department of Neurology of the Central Military Emergency Hospital, "Carol Davila" in the last two quarters of 2007, using a technique based on questionnaire (NMSQuest). Results. Patients included in this study were generally elderly, with a long relative history of disease. They are mostly in the moderate stage of disease and used treatment regimens with combinations of drugs. Prevalence of some non-motor symptoms according to the answers of patients in NMS questionnnaire (NMSQuest), like: depression, memory impairement sleep disturbances, sexual disturbances, "l...
Parkinson's disease symptoms -‘patients’ perceptions
Journal of Advanced Nursing, 1997
Parkinson's disease symptoms-patients' perceptions Self-assessment is significant for the accurate evaluation of patient' needs. This study examined the frequency and severity of symptoms reported by 39 patients with Parkinson's disease and compared them with symptoms suggested by the literature and by specialists as bothering Parkinson's patients. Four categories of symptoms were examined: (a) motor disability or activity loss, (b) mental change, (c) psychosocial difficulties, and (d) nonspecific symptoms. The findings show that there was correspondence between expert judgements and subjects' reports regarding symptoms such as dyskinesia/tremor as well as walking, freezing gait, and changing position. Symptoms such as dressing self, getting in/out of bed, morning stiffness and deficit in cognitive sequencing, which experts described as characteristic of Parkinson's disease patients, bothered subjects less. In general, patients' mental and psychosocial symptoms were higher in their frequencies and perceived severity than problems of performing activities of daily living.
Parkinson's Disease, 2011
Background. Nonmotor symptoms (NMS) of Parkinson's disease (PD) may be more debilitating than motor symptoms. The purpose of this study was to determine the frequency and corecognition of NMS among our advanced PD cohort (patients considered for deep brain stimulation (DBS)) and caregivers. Methods. NMS-Questionnaire (NMS-Q), a self-administered screening questionnaire, and NMS Assessment-Scale (NMS-S), a clinician-administered scale, were administered to PD patients and caregivers. Results. We enrolled 33 PD patients (23 males, 10 females) and caregivers. The most frequent NMS among patients using NMS-Q were gastrointestinal (87.9%), sleep (84.9%), and urinary (72.7%), while the most frequent symptoms using NMS-S were sleep (90.9%), gastrointestinal (75.8%), and mood (75.8%). Patient/caregiver scoring correlations for NMS-Q and NMS-S were 0.670 (P < 0.0001) and 0.527 (P = 0.0016), respectively. Conclusion The frequency of NMS among advanced PD patients and correlation between patients and caregivers varied with the instrument used. The overall correlation between patient and caregiver was greater with NMS-Q than NMS-S.
Movement Disorders, 2007
2006, there was, no single instrument (questionnaire or scale) for attempting a comprehensive assessment of the wide range of nonmotor symptoms (NMS) of Parkinson's disease (PD). The PD nonmotor group, a multidisciplinary group of experts including patient group representatives developed and validated the NMS screening questionnaire (NMSQuest) comprising 30 items. The NMSQuest is a self completed screening tool designed to draw attention to the presence of NMS. In this paper, we present the results gathered from 545 patients using the definitive version of the NMSQuest highlighting the prevalence of the wide range of NMS flagged in the NMSQuest from consecutive PD patients in an international setting. © 2007 Movement Disorder Society
Non-motor symptoms of Parkinson’s disease: the patient’s perspective
Journal of Neural Transmission, 2013
Parkinson's disease (PD) can be manifested in many different ways. Although motor dysfunction represents the best characterised of the symptoms, the nonmotor symptoms (NMS) of the condition can be equally disabling for people. These have been highlighted as being an issue of particular importance by people with PD. A comprehensive postal survey of members of the charity Parkinson's UK took place in 2008. This resulted in returns from 10,101 people with PD. The self-completed Non-Motor Questionnaire (NMSQuest) and quality of life scale (PDQ-8) were contained within the survey. The results showed that the percentage of people with PD experiencing NMS increased with the duration of the disease. However, people who had the younger onset form of the condition reported a greater impact of NMS, particularly in the areas of memory, depression and sleep function. There is an inverse correlation between NMS and (PDQ-8 scale). A significant number of people with PD reported that they experienced problems with olfaction, taste, nocturia and constipation prior to diagnosis and these may help to serve as a future biomarker for the condition. Although our understanding of PD-associated NMS has increased considerably in the recent past, there is still a general lack of awareness of the importance of NMS for people with PD. Further research is required to identify the best treatments that should be employed to address them.
Neurology, 2009
Background: Nonmotor symptoms (NMS) have a great impact on patients with Parkinson disease (PD). The Non-Motor Symptoms Scale (NMSS) is an instrument specifically designed for the comprehensive assessment of NMS in patients with PD. NMSS psychometric properties have been tested in this study. Methods: Data were collected in 12 centers across 10 countries in America, Asia, and Europe. In addition to the NMSS, the following measures were applied: Scales for Outcomes in Parkinson's Disease (SCOPA)-Motor, SCOPA-Psychiatric Complications (SCOPA-PC), SCOPA-Cognition, Hoehn and Yahr Staging (HY), Clinical Impression of Severity Index for Parkinson's Disease (CISI-PD), SCOPA-Autonomic, Parkinson's Disease Sleep Scale (PDSS), Parkinson's Disease Questionnaire-39 items (PDQ-39), and EuroQol-5 dimensions (EQ-5D). NMSS acceptability, reliability, validity, and precision were analyzed. Results: Four hundred eleven patients with PD, 61.3% men, were recruited. The mean age was 64.5 Ϯ 9.9 years, and mean disease duration was 8.1 Ϯ 5.7 years. The NMSS score was 57.1 Ϯ 44.0 points. The scale was free of floor or ceiling effects. For domains, the Cronbach ␣ coefficient ranged from 0.44 to 0.85. The intraclass correlation coefficient (0.90 for the total score, 0.67-0.91 for domains) and Lin concordance coefficient (0.88) suggested satisfactory reproducibility. The NMSS total score correlated significantly with SCOPA-Autonomic, PDQ-39, and EQ-5D (r S ϭ 0.57-0.70). Association was close between NMSS domains and the corresponding SCOPA-Autonomic domains (r S ϭ 0.51-0.65) and also with scales measuring related constructs (PDSS, SCOPA-PC) (all p Ͻ 0.0001). The NMSS total score was higher for women (p Ͻ 0.02) and for increasing disease duration, HY, and CISI-PD severity level (p Ͻ 0.001). The SEM was 13.91 for total score and 1.71 to 4.73 for domains. Conclusion: The Non-Motor Symptoms Scale is an acceptable, reproducible, valid, and precise assessment instrument for nonmotor symptoms in Parkinson disease. Neurology ® 2009;73: 1584-1591 GLOSSARY CCC ϭ concordance correlation coefficient; CISI-PD ϭ Clinical Impression of Severity Index for Parkinson's Disease; EQ-5D ϭ EuroQol-5 dimensions; HRQL ϭ health-related quality of life; HY ϭ Hoehn and Yahr Staging; ICC ϭ intraclass correlation coefficient; IRB ϭ institutional review board; MDS-UPDRS ϭ Movement Disorder Society-sponsored revision of the Unified Parkinson's Disease Rating Scale; NMS ϭ nonmotor symptoms; NMSQuest ϭ Non-Motor Symptoms Questionnaire; NMSS ϭ Non-Motor Symptoms Scale; PD ϭ Parkinson disease; PDQ-39 ϭ Parkinson's Disease Questionnaire-39 items; PDSS ϭ Parkinson's Disease Sleep Scale; SCOPA ϭ Scales for Outcomes in Parkinson's Disease; SCOPA-AUT ϭ Scales for Outcomes in Parkinson's Disease-Autonomic; SCOPA-COG ϭ Scales for Outcomes in Parkinson's Disease-Cognition; SCOPA-M ϭ Scales for Outcomes in Parkinson's Disease-Motor; SCOPA-PC ϭ Scales for Outcomes in Parkinson's Disease-Psychiatric Complications; SEM ϭ standard error of measurement; UPDRS ϭ Unified Parkinson's Disease Rating Scale; VAS ϭ visual analog scale. Nonmotor symptoms (NMS) are common in Parkinson disease (PD). Studies have found a prevalence ranging from 21% at the diagnosis of PD 1 to 88% after 7 years of disease duration. 2 In a large international sample, the average number of declared NMS was more than 10 symptoms, and less than 2% of patients did not experience any of the explored NMS. 3 NMS include autonomic dysfunction, mood disorders, fatigue, sleep disturbances, and neuropsychiatric symptoms. Patients experience an increasing number of NMS as the disease progresses, Authors' affiliations are listed at the end of the article.
European Neurological Review, 2009
A more widespread use of questionnaires and scales such as non-motor symptoms (NMS)-Quest and the non-motor symptoms scale (NMSS) has confirmed that NMS, such as sleeping difficulties and speech problems, are at least as troublesome for Parkinson’s disease patients as the major motor symptoms. These NMS can have a profound negative effect on patient quality of life and on the health of the person providing care. This fact is now receiving more attention in clinical practice and measures are being taken to improve the recognition and treatment of NMS, and to provide better support for care-givers. As our knowledge base of NMS expands, we are increasingly finding that some of them, e.g. olfactory deficit and rapid eye movement (REM) sleep behaviour disorder, also occur early in Parkinson’s disease, possibly pre-dating a diagnosis based on motor signs alone.