Consensus on the Definition of Advanced Parkinson’s Disease: A Neurologists-Based Delphi Study (CEPA Study)

Table 1

Percentages of respondents in both rounds.

Symptoms	% of participants
	First-round		Second-round
	Sufficiently and absolutely	Some, sufficiently, and absolutely	Absolutely	Sufficiently and absolutely	Some, sufficiently, and absolutely	Indicative symptoms of APD
(A) Motor symptoms related to treatment
Motor fluctuations	68.30			88.46
Duration of off periods > 25%	89.50		100.00
Off disability	92.10		100.00			84.62
Limitation to perform instrumental activities			47.83
Limitation to perform basic activities (but without help)			78.26
Requiring help for daily living activities			100.00
Durations of on dyskinesias > 25%	53.50
Functional disability due to dyskinesias	88.70			76.92		76.92
Limitation to perform instrumental activities			50.00
Limitation to perform basic activities (but without help)			90.00
Requiring help for daily living activities			100.00
(B) Motor symptoms related to the disease
Recurrent falls	87.80			100.00
Freezing of gait	82.60			96.15
Alteration of postural reflexes and equilibrium	88.70			92.31
Moderate or severe dysphagia	92.70			88.46		76.92
Moderate or severe dysarthria	77.40			76.92
(C) Neuropsychiatric and cognitive disorders
Moderate/severe depression	20.50	57.50		15.40	42.30
Mild cognitive impairment	29.50	76.50		26.90	69.20
Dementia	91.30	97.00		96.15		92.31
Chronic presence of hallucinations with preserved insight	39.50	83.80		50.00	80.80
Hallucinations without insight	83.50	95.70		92.31
Psychotic symptoms	73.50	91.80			92.31
Moderate/severe apathy	45.60	76.50		34.60	69.20
Impulse control disorders	29.10	65.20		38.40	42.20