Disease rating scales give clinicians a snapshot in time of the severity of a disease, how it may be affecting a patient, and areas where therapies may be applied. Put together over time, rating scale results can indicate the progression of a disease and possibly help with long term planning. In the case of Parkinson’s disease (PD), the Hoehn and Yahr scale, published in 1967, describes the progression of PD according to five stages from earliest to most advanced, based on severity of symptoms and level of disability. The Unified Parkinson’s Disease Rating Scale (UPDRS) consists of four parts, each of which encompasses several subparts to give an overall total score reflecting the severity of a person’s disease. In 2001, the Movement Disorder Society (MDS) took input from patients and care partners to incorporate into the UPDRS what was important to them and in 2008 published the revised MDS-UPDRS rating scale. Besides evaluating any one person’s disease, rating scales provide criteria for enrollment in clinical trials and help to compare trials and outcomes.

 

Although rating scales are important tools, and people with PD and their care partners want a gauge of their disease, often people tend to focus too heavily on the numbers whereas what is most important is how the disease is affecting them and how they cope with it. In this episode, Dr. Nina Browner, director of the Parkinson’s Foundation Center of Excellence at the University of North Carolina School of Medicine in Chapel Hill, gives her expert perspective on the use of rating scales and how people with PD may better understand their applicability and how much weight to give the numbers.