Validation of a UPDRS-/MDS-UPDRS-based definition of functional dependency for Parkinson's disease

Neil Ramsay, Angus D. MacLeod* (Corresponding Author), Guido Alves, Marta Camacho, Lars Forsgren, Rachael A. Lawson, Jodi Maple-Grødem, Ole-Bjørn Tysnes, Caroline H. Williams-Gray, Alison J. Yarnall, Carl E. Counsell, the Parkinson’s Incidence Cohorts Collaboration

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Introduction: Functional dependency in basic activities of daily living (ADLs) is a key outcome in Parkinson’s disease (PD). We aimed to define dependency in PD, using the original and MDS versions of the Unified Parkinson’s Disease Rating Scale (UPDRS). Methods: We developed two algorithms to define dependency from items of UPDRS Part 2 and MDSUPDRS Part 2 relating to basic ADLs (feeding, dressing, hygiene and walking, and getting out of a chair). We validated both algorithms using data from 1110 patients from six communitybased PD incidence cohorts, testing concurrent validity, convergent validity, and predictive validity. Results: Our optimal algorithm showed high specificity and moderate to high sensitivity versus Schwab & England <80% (specificity 95% [95% confidence interval (CI) 93-97] and sensitivity 65% [95% CI 55-73] at baseline; 88% [95% CI 85-91] and 85% [95% CI 79-97] respectively at five-years follow-up). Convergent validity was demonstrated by strong associations between dependency defined by the algorithm and cognition (MMSE), quality of life (PDQ39), and impairment (UPDRS part 3) (all p <0.001). Algorithm-defined dependency status also predicted mortality: HR for mortality in those dependent vs independent at baseline was 1.6 (95%CI 1.2-2.1) and in those dependent vs independent at five-years’ follow-up was 2.2 (1.6-3.0). Discussion: We have demonstrated the concurrent validity, convergent validity, and predictive validity of a UPDRS-/MDS-UPDRS-based algorithm to define functional dependency in PD. This can be used for studying dependency in any study where UPDRS or MDS-UPDRS part 2 data have been collected.
Original languageEnglish
Pages (from-to)49-53
Number of pages5
JournalParkinsonism & Related Disorders
Volume76
Early online date30 May 2020
DOIs
Publication statusPublished - Jul 2020

Keywords

  • Parkinson’s disease
  • Dependency
  • measurement scales
  • validation
  • Validation
  • Parkinson's disease
  • Measurement scales

Fingerprint Dive into the research topics of 'Validation of a UPDRS-/MDS-UPDRS-based definition of functional dependency for Parkinson's disease'. Together they form a unique fingerprint.

Cite this