EAN 2023 | Chaudhuri’s dashboard of vitals in Parkinson’s disease
K. Ray Chaudhuri, MD, DSc, FRCP, FEAN, King’s College London, London, UK, introduces a dashboard for people with Parkinson’s disease (PD), detailing the essential ‘vitals’ that should be considered and managed in every patient. The five vital of Parkinson’s compromise of signs or symptoms of disease that must not be missed, but are often overlooked in neurological consultations. These are: motor symptoms; non-motor symptoms; vision, gut, and oral health; bone health and falls; and comedication and comorbidities. Prof. Chaudhuri comments on how not addressing the vitals leads to inadequate management and has detrimental consequences to the wellness and quality of life of patients. The dashboard acts as a prompt, enabling clinicians to work through these signs and symptoms to ensure nothing is missed, and providing guidance on actions that should be taken. For example, evaluations should include assessment of non-motor symptom burden, osteoporosis, frailty, nyctalopia, H Pylori, periodontitis, diabetes, and anticholinergic use. Assessment of these vitals should be recorded annually to ensure holistic, personalized management for people with PD. This interview took place at the European Academy of Neurology (EAN) 2023 Congress in Budapest, Hungary.
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Transcript (edited for clarity)
The dashboard for Parkinson’s is something that we’ve recently published and it is a dashboard of five different, what we call the five vitals of Parkinson’s. The vitals are motor symptoms, non-motor symptoms as a whole, then gut vision and oral health, bone health, and then finally co-medications and co-morbidities. By doing so what we mean is some basics that must be done by everybody with Parkinson’s...
The dashboard for Parkinson’s is something that we’ve recently published and it is a dashboard of five different, what we call the five vitals of Parkinson’s. The vitals are motor symptoms, non-motor symptoms as a whole, then gut vision and oral health, bone health, and then finally co-medications and co-morbidities. By doing so what we mean is some basics that must be done by everybody with Parkinson’s.
The dashboard is a prompt to help the busy clinicians who may not be experts to do that in the clinic. It’s been widely endorsed by the patients and, for instance, many patients we find that bone health is not addressed, although we know that 2 in 5 women and 1 in 6 men over the age of 50 have osteoporosis, such patients must have their bones examined because otherwise they carry a serious risk of fractures if they fall. Similarly, many patients with Parkinson’s who might be on dopamine agonist drugs might be falling asleep while swimming, while driving, this is a hazard to their own health, can even cause fatalities. So, looking for a history of sudden onset of sleep is very important and the occupation of the patient. Similarly, we know that diabetes might have an adverse effect on Parkinson’s. We know that if you’ve got cognitive problems, you should not be given anticholinergic drugs. So, these are all flagged up in the dashboard so that when the patient comes to see the clinician, the clinician looks at the dashboard.
In future we want to have this as an app, and then they tick “Okay have I done this? Have I done this? Have I looked at the bone health?” Another example, Helicobacter pylori infection of the stomach, controversial, but still, it can delay absorption of levodopa. It can be easily diagnosed and treated. So, when somebody is saying the levodopa is not working very well have you checked the Helicobacter pylori, and have you treated that? Etc. So, this is all integrated into the dashboard and we very much hope that it will become incorporated in the pathway of care for Parkinson’s.
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