Reliability of Three Disability Scales for Detection of Independence Loss in Parkinson’s Disease

Background. Loss of independence is considered an important outcome measure in Parkinson’s disease (PD), but tools to assess dependency have not been tested in PD. Methods. In this study of 158 PD patients, we examined the two most widely used scales and cut-offs for dependency evaluation in PD, the...

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Main Authors: Anders Bjornestad, Ole-Bjorn Tysnes, Jan Petter Larsen, Guido Alves
Format: Article
Language:English
Published: Wiley 2016-01-01
Series:Parkinson's Disease
Online Access:http://dx.doi.org/10.1155/2016/1941034
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author Anders Bjornestad
Ole-Bjorn Tysnes
Jan Petter Larsen
Guido Alves
author_facet Anders Bjornestad
Ole-Bjorn Tysnes
Jan Petter Larsen
Guido Alves
author_sort Anders Bjornestad
collection DOAJ
description Background. Loss of independence is considered an important outcome measure in Parkinson’s disease (PD), but tools to assess dependency have not been tested in PD. Methods. In this study of 158 PD patients, we examined the two most widely used scales and cut-offs for dependency evaluation in PD, the Hoehn and Yahr (HY) stage > 3 and the Schwab and England (SE) scale score < 80%, against a standardized clinical interview assessing dependency in activities of daily living (ADL). We also examined the performance of the generic Barthel ADL index. In addition, we determined whether alternative cut-offs improved the utility of these tools. Results. Compared to clinical interview as gold standard, HY stage > 3 had 21% sensitivity and 98% specificity in detecting dependency in ADL. Corresponding figures for SE score < 80% were 55% and 92%, respectively. Using alternative cut-off values improved the overall diagnostic accuracy only slightly. Barthel ADL index had 67% sensitivity and 78% specificity in detecting dependency at its optimal cut-off value. Conclusion. Both the disease-specific HY staging and SE scale and the generic Barthel ADL index are suboptimal tools for assessing independence loss in PD. Clinical interview should be the assessment of choice in studies of dependency.
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spelling doaj-art-2290d11f59e1407e86bd3a3a13c635902025-08-20T02:04:37ZengWileyParkinson's Disease2090-80832042-00802016-01-01201610.1155/2016/19410341941034Reliability of Three Disability Scales for Detection of Independence Loss in Parkinson’s DiseaseAnders Bjornestad0Ole-Bjorn Tysnes1Jan Petter Larsen2Guido Alves3The Norwegian Centre for Movement Disorders, Stavanger University Hospital, 4068 Stavanger, NorwayInstitute of Clinical Medicine, University of Bergen, 5021 Bergen, NorwayThe Norwegian Centre for Movement Disorders, Stavanger University Hospital, 4068 Stavanger, NorwayThe Norwegian Centre for Movement Disorders, Stavanger University Hospital, 4068 Stavanger, NorwayBackground. Loss of independence is considered an important outcome measure in Parkinson’s disease (PD), but tools to assess dependency have not been tested in PD. Methods. In this study of 158 PD patients, we examined the two most widely used scales and cut-offs for dependency evaluation in PD, the Hoehn and Yahr (HY) stage > 3 and the Schwab and England (SE) scale score < 80%, against a standardized clinical interview assessing dependency in activities of daily living (ADL). We also examined the performance of the generic Barthel ADL index. In addition, we determined whether alternative cut-offs improved the utility of these tools. Results. Compared to clinical interview as gold standard, HY stage > 3 had 21% sensitivity and 98% specificity in detecting dependency in ADL. Corresponding figures for SE score < 80% were 55% and 92%, respectively. Using alternative cut-off values improved the overall diagnostic accuracy only slightly. Barthel ADL index had 67% sensitivity and 78% specificity in detecting dependency at its optimal cut-off value. Conclusion. Both the disease-specific HY staging and SE scale and the generic Barthel ADL index are suboptimal tools for assessing independence loss in PD. Clinical interview should be the assessment of choice in studies of dependency.http://dx.doi.org/10.1155/2016/1941034
spellingShingle Anders Bjornestad
Ole-Bjorn Tysnes
Jan Petter Larsen
Guido Alves
Reliability of Three Disability Scales for Detection of Independence Loss in Parkinson’s Disease
Parkinson's Disease
title Reliability of Three Disability Scales for Detection of Independence Loss in Parkinson’s Disease
title_full Reliability of Three Disability Scales for Detection of Independence Loss in Parkinson’s Disease
title_fullStr Reliability of Three Disability Scales for Detection of Independence Loss in Parkinson’s Disease
title_full_unstemmed Reliability of Three Disability Scales for Detection of Independence Loss in Parkinson’s Disease
title_short Reliability of Three Disability Scales for Detection of Independence Loss in Parkinson’s Disease
title_sort reliability of three disability scales for detection of independence loss in parkinson s disease
url http://dx.doi.org/10.1155/2016/1941034
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