Toggle Main Menu Toggle Search

Open Access padlockePrints

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

Lookup NU author(s): Dr Rachael LawsonORCiD, Dr Alison Yarnall

Downloads


Licence

This is the authors' accepted manuscript of an article that has been published in its final definitive form by Elsevier Ltd, 2020.

For re-use rights please refer to the publisher's terms and conditions.


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 MDS-UPDRS 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 community-based 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.


Publication metadata

Author(s): Ramsay N, Macleod AD, Alves G, Camacho M, Forsgren L, Lawson RA, Maple-Grødem J, Tysnes OB, Williams-Gray CH, Yarnall AJ, Counsell CE

Publication type: Article

Publication status: Published

Journal: Parkinsonism and Related Disorders

Year: 2020

Volume: 76

Pages: 49-53

Print publication date: 01/07/2020

Online publication date: 30/05/2020

Acceptance date: 26/05/2020

Date deposited: 04/06/2020

ISSN (print): 1353-8020

ISSN (electronic): 1873-5126

Publisher: Elsevier Ltd

URL: https://doi.org/10.1016/j.parkreldis.2020.05.034

DOI: 10.1016/j.parkreldis.2020.05.034


Altmetrics

Altmetrics provided by Altmetric


Funding

Funder referenceFunder name
146281
177966
287842
911218
G-1301
J-0802Parkinson`s UK (formerly Parkinson`s Disease Society)
G-1507
MR/R007446/1

Share