Rating scales for Parkinson's disease: when and how to use them

In Parkinson's disease, rating scales are used to assess the degree of disease-related disability and to titrate treatment to each phase of the disease course. Clinicians should be widely aware of these scales and know how to use them. The UPDRS is the most widely used, having proven intra- and inter-observer validity. The purely motor items of the UPDRS allow an evaluation of response to dopaminergic treatment Scales including all aspects of the disease, motor, cognitive and psychiatric impairment, can also be used. Some of the simple scales can be used at consultation or the patientis bedside, others require experience in psychological care. They are useful in daily practice for patient follow-up and facilitate communication between caregivers. Quality of life scales have been developed more recently. These scales take into account the patientis own perception of his/her disability and its impact on daily activities. Finally, motor and cognitive disability scales are used in clinical research protocols.