MDS-UPDRS

Full Name *

I. Non-Motor Aspects of Experiences of Daily Living (nM-EDL)

1.7 Sleep problems *

No problems (0)

Sleep problems are present but usually do not cause trouble getting a full night of sleep (1)

Sleep problems usually cause some difficulties getting a full night of sleep (2)

Sleep problems cause a lot of difficulties getting a full night of sleep, but I still usually sleep for more than half the night (3)

I usually do not sleep for most of the night (4)

1.8 Daytime sleepiness *

No daytime sleepiness (0)

Daytime sleepiness occurs but I can resist and I stay awake (1)

Sometimes I fall asleep when alone and relaxing. For example while reading or watching TV (2)

I sometimes fall asleep when I should not. For example, while eating or talking with other people (3)

I often fall asleep when I should not. For example, while eating or talking with other people (4)

1.9 Pain and other sensations *

No uncomfortable feelings (0)

I have these feelings. However, I can do things and be with other people without difficulties (1)

These feelings cause some problems when I do things or am with other people (2)

These feelings cause a lot of problems, but they do not stop me from doing things or being with other people(3)

These feelings stop me from doing things or being with other people (4)

Over the past week, have you had uncomfortable feelings in your body like pain, aches tingling or cramps?

1.10 Urinary problems *

No urine control problems (0)

I need urinate often or urgently. However, these problems do not cause difficulties with my daily activities (1)

Urine problems cause some difficulties with my daily activities. However, I do not have urine accidents (2)

Urine problems cause a lot of difficulties with my daily activities, including urine accidents (3)

I cannot control my urine and use a protective garment or have a bladder tube (4)

1.11 Constipation *

No constipation (0)

I have been constipated. I use extra effort to move my bowels. However, this problem does not disturb my activities or my being comfortable (1)

Constipation causes me to have some troubles doing things or being comfortable (2)

Constipation causes me to have a lot of trouble doing things or being comfortable. However, it does not stop me from doing anything (3)

I usually need physical help from someone else to empty my bowels (4)

1.12 Light headedness on standing *

No dizzy or foggy feelings (0)

Dizzy or foggy feelings occur. However, they do not cause me troubles doing things (1)

Dizzy or foggy feelings cause me to hold on to something, but I do not need to sit or lie back down (2)

Dizzy or foggy feelings cause me to sit or lie down to avoid fainting or falling (3)

Dizzy or foggy feelings cause me to fall or faint (4)

1.13 Fatigue *

No fatigue (0)

Fatigue occurs. However it does not cause me troubles doing things or being with people (1)

Fatigue causes me some troubles doing things or being with people (2)

Fatigue causes me a lot of troubles doing things or being with people. However, it does not stop me from doing anything (3)

Fatigue stops me from doing things or being with people (4)

II. Motor aspects of experiences of daily living (M-EDL)

2.1 Speech *

Not at all (no problems) (0)

My speech is soft, slurred or uneven, but it does not cause others to ask me to repeat myself (1)

My speech causes people to ask me to occasionally repeat myself, but not everyday (2)

My speech is unclear enough that others ask me to repeat myself every day even though most of my speech is understood (3)

Most or all of my speech cannot be understood (4)

2.2 Saliva & drooling *

Not at all (no problems) (0)

I have too much saliva, but do not drool (1)

I have some drooling during sleep, but none when I am awake (2)

I have some drooling when I am awake, but I usually do not need tissues or a handkerchief (3)

I have so much drooling that I regularly need to use tissues or a handkerchief to protect my clothes (4)

2.3 Chewing and swallowing *

No problems (0)

I am aware of slowness in my chewing or increased effort at swallowing, but I do not choke or need to have my food specially prepared (1)

I need to have my pills cut or my food specially prepared because of chewing or swallowing problems, but I have not choked over the past week (2)

I chocked at least once in the past week (3)

Because of chewing and swallowing problems, I need a feeding tube (4)

2.4 Eating tasks *

Not at all (no problems) (0)

I am slow, but I do not need any help handling my food and have not had food spills while eating (1)

I am slow with my eating and have occasional food spills. I may need help with a few tasks such as cutting meat (2)

I need help with many eating tasks but can manage some alone (3)

I need help for most or all eating tasks (4)

2.5 Dressing *

Not at all (no problems) (0)

I am slow but I do not need help (1)

I am slow and need help for a few dressing tasks (buttons, bracelets) (2)

I need help for many dressing tasks (3)

I need help for most or all dressing tasks (4)

2.6 Hygiene *

Not at all (no problems) (0)

I am slow but I do not need help (1)

I need someone else to help me with some hygiene tasks (2)

I need help for many hygiene tasks (3)

I need help for most or all of my hygiene tasks (4)

Over the past week, have you usually been slow or do you need help with washing, bathing, shaving, brushing teeth, combing your hair or with other personal hygiene?

2.7 Handwriting *

Not at all (no problems) (0)

My writing is slow, clumsy or uneven, but all words are clear (1)

Some words are unclear and difficult to read (2)

Many words are unclear and difficult to read (3)

Most or all words cannot be read (4)

2.8. Doing hobbies and other activities *

Not at all (no problems) (0)

I am a bit slow but do these activities easily (1)

I have some difficulties doing these activities (2)

I have major problems doing these activities, but still do most (3)

I am unable to do most or all of these activities (4)

2.9 Turning in bed *

Not at all (no problems) (0)

I have a bit of trouble turning, but I do not need any help (1)

I have a lot of trouble turning and need occasionally help from someone elses (2)

To turn over I often need help from someone else (3)

I am unable to turn over without help from someone else (4)

2.10 Tremor *

Not at all. I have no shaking or tremor (0)

Shaking or tremor occurs but does not cause problems with any activities (1)

Shaking or tremor causes problems with only a few activities (2)

Shaking or tremor causes problems with many of my daily activities (3)

Shaking or tremor causes problems with most or all activities (4)

2.11 Getting out of bed, a car or a deep chair *

Not at all (no problems) (0)

I am slow or awkward, but I usually can do it on my first try (1)

I need more than one try to get up or need occasionally help (2)

I sometimes need help to get up, but most times I can still do it on my own (3)

I need help most or all of the time (4)

2.12 Walking and balance *

Not at all (no problems) (0)

I am slightly slow or may drag a leg. I never use a walking aid (1)

I occasionally use a walking aid, but I do not need any help from another person (2)

I usually use a walking aid (cane, walker) to walk safely without falling. However, I do not usually need the support of another person (3)

I usually use the support of another person to walk safely without falling (4)

2.13 Freezing *

Not at all (no problems) (0)

I briefly freeze but I can easily start walking again. I do not need help from someone else or a walking aid (cane or walker) because of freezing (1)

I freeze and have trouble starting to walk again, but I do not need someone’s help or a walking aid (cane or walker) because of freezing (2)

When I freeze I have a lot of trouble starting to walk again and, because of freezing, I sometimes need to use a walking aid or need someone else’s help (3)

Because of freezing, most or all of the time, I need to use a walking aid or someone’s help (4)

Message