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

Table 2

Results obtained in the third-round.

Level of relevance	General characteristics	Disability	Motor symptoms related with treatment	Motor symptoms related with the disease	Nonmotor symptoms related with the disease	Neuropsychiatric and cognitive symptoms
Definitive symptoms		Requiring help to perform daily living activities	Presence of motor fluctuations with an off time > 25%, with limitation to perform basic activities, without requiring help	Severe dysphagia; Recurrent falls		Dementia
Probablesymptoms	Evolution time (around 10 years)	Limitation to perform basic activities, although not requiring help	Functional disability due to dyskinesias with an on time > 25%	Moderate dysphagia; Freezing of gait; Moderate-severe dysarthria		Hallucinations without preserved insight
symptoms				Postural and equilibrium disorders	Symptomatic dysautonomia, including orthostatic symptomatic hypotension,; excessive daytime somnolence	Moderate-severe apathy; Chronic presence of hallucinations with preserved insight; Psychotic symptoms; Mild cognitive impairment

The association of two probable symptoms of different areas (general characteristics, disability, motor symptoms related to treatment, etc.) makes them a definite symptom.
The association of one possible motor or nonmotor symptom related with the disease areas with one possible symptom of the neuropsychiatric and cognitive area makes them a probable symptom.