Clinical Rating Scales for Urinary Symptoms in Parkinson Disease: Critique and Recommendations

Abstract

Background The prevalence of lower urinary tract symptoms (LUTS) is high in Parkinson's disease (PD). These problems negatively affect quality of life and include both storage and voiding problems. The International Parkinson and Movement Disorder Society established a task force to review clinical rating scales/questionnaires for the assessment of urinary symptoms in PD. Methods According to prespecified criteria, these scales/questionnaires were classified as “Recommended” or “Recommended with caveats” when clinimetric properties were satisfactory for Recommended status but had not been assessed specifically in PD, “Suggested” or “Listed.” These assessments were applied to rate scales as screening tools for the diagnosis of LUTS and for the rating of symptom severity. Results Among scales that included LUTS but focused on overall autonomic or non‐motor symptoms in PD, no scale reached the clinimetric rigor to be designated as Recommended or Recommended with caveats, but some were Suggested for either diagnostic screening tools or severity measures. Among primary urological scales, most are well validated in urological setting, but none was validated specifically in PD. DAN‐PSS (Danish PSS), ICIQ (International Consultation for Incontinence Questionnaire)‐MLUTS (Male Lower Urinary Tract Symptoms), OABq, OABq‐SF (ICIQ‐OABqol), OAB‐V8 (as screening tool), and OABSS (OAB Symptom Score) met criteria for Recommended with caveats. Conclusion The Task Force does not recommend the development of a new scale. However, all above‐mentioned questionnaires need to be studied further and specifically validated in PD.

Lower Urinary Tract and Gastrointestinal Dysfunction Are Common in Early Parkinson’s Disease

“…Identification of these patients with early PD is crucial for developing therapeutic strategies to prevent complications. Some validated questionnaires and clinical rating scales are useful for easily detecting and characterizing autonomic symptoms in clinical practice [ 8 ]. The Scales for Outcomes in Parkinson's Disease-Autonomic dysfunction (SCOPA-AUT) is a clinical questionnaire that assesses the presence and frequency of autonomic symptoms in patients with PD [ 9 ].…”

Lower Urinary Tract Symptoms in Nigerian Men With Parkinsons Disease

“…Other researchers have also utilized the IPSS questionnaire to evaluate LUTS in Parkinson disease patients and found it useful irrespective of the patient"s gender. 6,12,13 There are many PD rating scales in use for staging the Parkinson"s disease severity. We utilized the Unified Parkinson"s Disease Rating Scale (UPDRS), which is a validated and standardized questionnaire for the holistic assessment of the severity and impact of PD on the patient.…”

“…LUTS are generally stratified using the IPSS into mild (1-7), moderate (8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19) and severe (19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35). (Tables 2) This categorization was applied to the patient with PD in our study and it was observed that most of the patients had mild to moderate symptoms.…”

Autonomic Dysfunction in Parkinson's Disease

“…The Scales for Outcomes in Parkinson's Disease-Autonomic (SCOPA-AUT) specifically addresses autonomic dysfunction in PD and is perhaps the most frequently used scale for this purpose. Other scales have been developed for the assessment of individual features of autonomic dysfunction but, generally, have not been validated specifically for PD [8,9]. The Movement Disorder Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS) contains questions pertaining to autonomic dysfunction, some of which correlate well with the SCOPA-AUT [10].…”