The pill questionnaire in a nondemented Parkinson's disease population§

Authors

  • William Reginold,

    1. Toronto Western Hospital Movement Disorders Centre, and the Edmond J. Safra Program in Parkinson's Disease, Toronto, Ontario, Canada
    2. Department of Medicine (Neurology), University of Toronto, Toronto, Ontario, Canada
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  • Melissa J. Armstrong MD,

    1. Toronto Western Hospital Movement Disorders Centre, and the Edmond J. Safra Program in Parkinson's Disease, Toronto, Ontario, Canada
    2. Department of Medicine (Neurology), University of Toronto, Toronto, Ontario, Canada
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  • Sarah Duff-Canning PhD, CPsych,

    1. Department of Neuropsychology, Toronto Western Hospital, Toronto, Ontario, Canada
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  • Anthony Lang MD,

    1. Toronto Western Hospital Movement Disorders Centre, and the Edmond J. Safra Program in Parkinson's Disease, Toronto, Ontario, Canada
    2. Department of Medicine (Neurology), University of Toronto, Toronto, Ontario, Canada
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  • David Tang-Wai MD,

    1. Toronto Western Hospital Movement Disorders Centre, and the Edmond J. Safra Program in Parkinson's Disease, Toronto, Ontario, Canada
    2. Department of Medicine (Neurology), University of Toronto, Toronto, Ontario, Canada
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  • Susan Fox MD, PhD,

    1. Toronto Western Hospital Movement Disorders Centre, and the Edmond J. Safra Program in Parkinson's Disease, Toronto, Ontario, Canada
    2. Department of Medicine (Neurology), University of Toronto, Toronto, Ontario, Canada
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  • Brandon Rothberg HBA,

    1. Toronto Western Hospital Movement Disorders Centre, and the Edmond J. Safra Program in Parkinson's Disease, Toronto, Ontario, Canada
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  • Cindy Zadikoff MD,

    1. Department of Neurology, Northwestern University, Chicago, Illinois, USA
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  • Nancy Kennedy PhD,

    1. Department of Psychiatry and Behavioral Science, Northwestern University, Chicago, Illinois, USA
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  • David Gill MD,

    1. Department of Neurology, PennState Hershey, Hershey, Pennsylvania, USA
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  • Paul Eslinger PhD,

    1. Department of Neurology, PennState Hershey, Hershey, Pennsylvania, USA
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  • Mark Mapstone PhD,

    1. Department of Neurology, University of Rochester, Rochester, New York, USA
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  • Kelvin Chou MD,

    1. Department of Neurology, University of Michigan, Ann Arbor, Michigan, USA
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  • Carol Persad PhD,

    1. Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA
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  • Irene Litvan MD, FAAN,

    1. Department of Neurology, University of Louisville, Louisville, Kentucky, USA
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  • Benjamin Mast PhD,

    1. Psychological & Brain Sciences, University of Louisville, Louisville, Kentucky, USA
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  • Connie Marras MD, PhD

    Corresponding author
    1. Toronto Western Hospital Movement Disorders Centre, and the Edmond J. Safra Program in Parkinson's Disease, Toronto, Ontario, Canada
    2. Department of Medicine (Neurology), University of Toronto, Toronto, Ontario, Canada
    • Movement Disorders Centre, McL 7-421, Toronto Western Hospital, 399 Bathurst Street, Toronto, Ontario M5T 2S8, Canada
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  • Funding agencies: This study was funded by the Michael J. Fox Foundation for Parkinson's Research.

  • Relevant conflicts of interest/financial disclosures: Connie Marras is supported by a New Investigator Award from the Canadian Institutes for Health Research.

  • §

    Full financial disclosures and author roles may be found in the online version of this article.

Abstract

We assessed the Pill Questionnaire as a screen for mild cognitive impairment in nondemented Parkinson's disease patients.

The relationship between ability to remember medications for Parkinson's disease in the Pill Questionnaire, mild cognitive impairment, and deficits on neuropsychological tests performed 2–3 weeks later blind to Pill Questionnaire results was assessed in movement disorders clinic patients.

In 109 subjects, inaccurate medication reporting on the Pill Questionnaire was associated with lower scores on the Montreal Cognitive Assessment, Scales for Outcomes in Parkinson's Disease–Cognition and with deficits in memory, attention, executive function-inhibitory control, processing speed, visuospatial function, and language. Inaccurate medication reporting was also associated with an adjusted odds ratio of 2.4 (95% CI, 0.91–5.88; P = .06) for mild cognitive impairment, with a specificity of 80% and sensitivity of 41%.

The Pill Questionnaire is neither sensitive nor specific enough to be used as the sole screening or diagnostic tool for mild cognitive impairment. However, inaccurate medication reporting is associated with deficits spanning many cognitive domains and should alert a clinician to a higher likelihood of cognitive impairment. © 2012 Movement Disorder Society

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