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Tests for Depression and Dementia
The American Academy of Neurology (AAN) recommends the Beck Depression Inventory or the Hamilton Depression Rating Scale to screen for depression in patients with Parkinson's disease. The AAN recommends the Mini Mental State Examination (MMSE) and Cambridge Cognitive Examination (CAMCOG) tests to screen for dementia. During these tests, the patient answers a series of questions.
Ruling out Conditions that Mimic Parkinson's Disease
Parkinsonism Plus Syndromes. Parkinson’s disease is the most common type of parkinsonism. Parkinsonism refers to a group of movement disorders that share similar symptoms with Parkinson’s disease, but also have unique symptoms of their own. About 15% of parkinsonism cases are due to conditions called Parkinson’s plus syndromes (PPS) or atypical parkinsonism. These syndromes include:
- Corticobasal degeneration. Marked by apraxia (inability to perform coordinated movements or use familiar objects), stiffness that is more severe than typical Parkinson’s disease, and twitching or jerking in the hand.
- Lewy body dementia. One of the most common types of progressive dementia. Symptoms include visual hallucinations and loss of spontaneous movement.
- Multiple system atrophy. Symptoms include fainting, constipation, erectile dysfunction, urinary retention, and loss of muscle coordination.
- Progressive supranuclear palsy. Marked by frequent falls, personality changes, and difficulty focusing the eyes.
Patients with PPS often have earlier and more severe dementia than those with Parkinson’s disease. In addition, they do not usually respond to medications that are used to treat Parkinson’s disease.
Other Neurologic Conditions. Many medical conditions may cause some symptoms of Parkinson's disease and parkinsonism. Hardening of the arteries (arteriosclerosis) in the brain can cause multiple small strokes, which can produce loss of motor control. Alzheimer’s disease can share similar symptoms with Parkinson’s and the conditions can exist together.
Medications. A number of drugs, including antipsychotic and antiseizure medications, can cause Parkinson’s symptoms.
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Review Date: 06/18/2010
Reviewed By: Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine,
Harvard Medical School; Physician, Massachusetts General Hospital.
Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M.,
Inc.
A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org)
