Validation of a UPDRS-/MDS-UPDRS-based definition of functional dependency for Parkinson's disease.
Macleod, Angus D
Lawson, Rachael A
Yarnall, Alison J
Counsell, Carl E
Parkinson's Incidence Cohorts Collaboration,
ParkWest Study: ParkWest Principal investigators,
Parkinsonism & related disorders
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Ramsay, N., Macleod, A. D., Alves, G., Camacho, M., Forsgren, L., Lawson, R. A., Maple-Grødem, J., et al. (2020). Validation of a UPDRS-/MDS-UPDRS-based definition of functional dependency for Parkinson's disease.. Parkinsonism & related disorders, 76 49-53. https://doi.org/10.1016/j.parkreldis.2020.05.034
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.
Parkinson's Incidence Cohorts Collaboration, PINE Study, CamPaIGN study, PICNICS study, NYPUM Study, ParkWest Study: ParkWest Principal investigators, Study personnel, ICICLE-PD Study, Humans, Parkinson Disease, Sensitivity and Specificity, Cohort Studies, Reproducibility of Results, Algorithms, Aged, Middle Aged, Female, Male, Mental Status and Dementia Tests, Functional Status
The PICC collaboration was funded by the Chief Scientist Office of the Scottish Government, NHS Education for Scotland, and the Academy of Medical Sciences. The CamPaIGN study has received funding from the Wellcome Trust, the Medical Research Council, the Patrick Berthoud Trust, Parkinson’s UK, and the National Institute for Health Research (NIHR) Cambridge Biomedical Research Centre Dementia and Neurodegeneration Theme (ref. 146281). The ICICLE-PD study was funded by Parkinson's UK (J-0802, G-1301, G-1507) and the, Lockhart Parkinson's Disease Research Fund. The research was supported by the NIHR Newcastle Biomedical Research Unit and Centre based at Newcastle upon Tyne Hospitals NHS Foundation Trust and Newcastle University, and the National Institute for Health Research (NIHR) Cambridge Biomedical Research Centre Dementia and Neurodegeneration Theme (ref. 146281). The NYPUM study was funded by Swedish Medical Research Council, Parkinson Foundation in Sweden, the Swedish Parkinson Disease Association, University of Umeå, Foundation for Clinical Neuroscience at Umeå University Hospital, Västerbotten County Council (ALF) and King Gustaf V's and Queen Victoria's foundation The Norwegian ParkWest study was funded by the Western Norway Regional Health Authority (grant No 911218), the Research Council of Norway (grant No 177966 and 287842) and the Norwegian Parkinson Research Foundation. The PICNICS study was funded by the Cure Parkinson’s Trust, the Van Geest Foundation, the MRC and Parkinson’s UK, and the National Institute for Health Research (NIHR) Cambridge Biomedical Research Centre Dementia and Neurodegeneration Theme (ref. 146281). The PINE study was funded by Parkinson’s UK, the Scottish Chief Scientist Office, NHS Grampian endowments, the BMA Doris Hillier award, RS Macdonald Trust, the BUPA Foundation and SPRING. C H Williams-Gray holds a RCUK/UKRI Research Innovation Fellowship awarded by the Medical Research Council (MR/R007446/1) and receives support from the Cambridge Centre for Parkinson-Plus.
Cambridge University Hospitals NHS Foundation Trust (CUH) (146281)
External DOI: https://doi.org/10.1016/j.parkreldis.2020.05.034
This record's URL: https://www.repository.cam.ac.uk/handle/1810/306605
Attribution-NonCommercial-NoDerivatives 4.0 International
Licence URL: https://creativecommons.org/licenses/by-nc-nd/4.0/