What are the key clinical features to consider when diagnosing Parkinson's Disease in a primary care setting?

Key clinical features to consider when diagnosing Parkinson's disease in primary care include:

• Tremor, typically a resting tremor.
• Bradykinesia, which is slowness of movement.
• Muscle rigidity or stiffness.
• Postural instability or balance problems, often manifesting as gait disorders.
• Non-motor symptoms that may contribute to poor quality of life, such as cognitive impairment, mood disorders, and autonomic dysfunction, should also be considered.
• Exclude drug-induced parkinsonism by reviewing medications known to cause parkinsonian symptoms.
• Early falls soon after symptom onset may suggest alternative diagnoses and warrant urgent specialist referral.
• Diagnosis is clinical and should follow established criteria such as the UK Parkinson's Disease Society Brain Bank Clinical Diagnostic Criteria.
• Refer people suspected of having Parkinson's disease urgently and untreated to a specialist with expertise in movement disorders for confirmation and exclusion of alternative diagnoses.

These features guide the initial suspicion and referral process in primary care to ensure accurate diagnosis and timely specialist involvement.

References: ¹,²