Abstract
Background There are very few epidemiological studies investigating Parkinson's disease (PD) in Africa. The hundreds of local languages and dialects make traditional screening and clinical evaluation tools difficult to use. Objective The objective of the study was to validate two commonly used PD questionnaires in an African population. Methods The PD Screening Questionnaire (PDSQ) and Parkinson's Disease Questionnaire (PDQ-39) were modified and translated into Afrikaans, Setswana, and isiZulu and administered to a sample of healthy local residents. We assessed the internal consistencies and cluster characteristics of the questionnaires, using a Cronbach's alpha test and exploratory factor analysis. The questionnaires were then administered to a population-based sample of 416 research participants. We evaluated the correlations between the questionnaires and both a timed motor task and the Unified Parkinson's Disease Rating Scale motor subsection 3 (UPDRS3), using locally weighted scatterplot smoothing (LOWESS) regression analysis and Spearman's rank correlation. Results Both questionnaires had high overall internal consistency (Cronbach's alpha = 0.86 and 0.95, respectively). The modified PDQ-39 had evidence of five subscales, with Factor 1 explaining 57% and Factor 2 explaining 14%, of the variance in responses. The PDSQ and PDQ-39 scores were correlated with the UPDRS3 score (ρ = 0.35, P < 0.001; and ρ = 0.28, P < 0.001, respectively). Conclusion The translated PDSQ and PDQ-39 questionnaires demonstrated high internal consistency and correlations with clinical severity of parkinsonism and a timed motor task, suggesting that they are valid tools for field-based epidemiological studies.
Highlights
Introduction e global impact ofParkinson’s disease (PD) is expected to reach pandemic proportions with the aging of both developed and developing country populations [1,2,3,4]
We evaluated the correlations between the questionnaires and both a timed motor task and the Unified Parkinson’s Disease Rating Scale motor subsection 3 (UPDRS3), using locally weighted scatterplot smoothing (LOWESS) regression analysis and Spearman’s rank correlation
E PD Screening Questionnaire comprises nine questions to elicit self-reported symptoms typical of PD to screen populations for PD, answered as “yes” or “no.” It has been widely used in epidemiological studies. e PDQ-39 is a validated PD-specific quality of life questionnaire comprised of 39 questions that assess mobility, activities of daily living, emotional well-being, stigma, social support, cognitions, communication, and bodily discomfort in patients with PD
Summary
Gill Nelson ,1,2 Ntombizodwa Ndlovu ,1 Nicola Christofides ,1 Tintswalo M. E translated PDSQ and PDQ-39 questionnaires demonstrated high internal consistency and correlations with clinical severity of parkinsonism and a timed motor task, suggesting that they are valid tools for field-based epidemiological studies. Performances on the PDQ-39 and PDSQ were validated against two methods of assessing motor function: (1) a Purdue Grooved Pegboard timed test [12] was used to measure fine motor speed and visuomotor coordination (times taken to complete the task with the dominant and nondominant hand were recorded), and (2) the Unified Parkinson’s Disease Rating Scale motor subsection 3 (UPDRS3) [13] was administered by a movement disorders specialist without knowledge of the responses in either questionnaire. E PDQ-39 and PDSQ scores were strongly correlated (ρ 0.64; P < 0.001) (Figure 1)
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