Objective: The aim of this study was to validate the new diagnostic criteria for fatigue1 in Parkinson’s disease patients.

Background: Case definition and diagnostic criteria for fatigue in Parkinson’s disease have been published recently, nevertheless they have not been validated so far.

Methods: Sociodemographic data, diagnostic criteria for fatigue in PD and other scales including the MDS-UPDRS, Multidimensional Fatigue Inventory (MFI), Fatigue Severity Scale (FSS), Beck Depression Inventory-II (BDI-II), Apathy scale (AS) and Epsworth Sleepiness Scale (ESS) were examined in a sample of 95 consecutive patients with Parkinson’s disease. Prevalence of fatigue based on the new diagnostic criteria, FSS and MFI was evaluated. Reliability of the diagnostic criteria for fatigue was assessed using Cronbach’s alpha for internal consistency and intra-class correlation coefficients for test-retest reliability. Convergent validity with the FSS and MFI and divergent validity with the BDI-II, ESS and AS were assessed using ROC analyses.

Results: Mean age of the patient sample was 66.2 years (range 41-83), 53 patients were men, mean disease duration 7.4±5.1 years, median HY stage 2 (interquartile range 2-3). Fatigue was present in 27 patients (28.4%) based on the new diagnostic criteria, 57 patients (60%) based on the FSS and 60 patients (63.2%) based on the MFI. The new diagnostic criteria for fatigue have an excellent internal consistency with Cronbach’s alpha 0,90 and excellent test-retest reliability with intra-class coefficient 0.93 (95%CI 0.89-0.95). Convergent validity with FSS was acceptable with AUC 0.75 (95%CI 0.64-0.87) and convergent validity with MFI was ranging from AUC 0.69 (95%CI 0.57-0.81) for MFI physical fatigue to AUC 0.79 (95%CI 0.68-0.90) for MFI mental fatigue. Divergent validity with BDI-II was moderate with AUC 0.60 (95%CI 0.42-0.73), AUC for AS was 0.65 (95%CI 0.52-0.78) and AUC for ESS was 0.66 (95%CI 0.52-0.80).

Conclusions: The new diagnostic criteria for fatigue in Parkinson’s disease show good psychometric properties with excellent reliability and acceptable validity and thus can be used in future PD-related fatigue research.

References: 1. Kluger BM, Herlofson K, Chou KL, et al. Parkinson’s disease-related fatigue: a case definition and recommendations for clinical research. Mov Disord 2016; 31: 625-631.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/validation-of-the-new-diagnostic-criteria-for-fatigue-in-parkinsons-disease/