MDS-UPDRS Part I – Non-Motor Experiences of Daily Living
Non-motor experiences of daily living in Parkinson’s disease. 13 items, total 0 to 52.
By Claire White
- 13 items in two blocks. Part IA, items 1.1 to 1.6, is rated by the investigator. Part IB, items 1.7 to 1.13, is completed by the person, with or without a carer's help.
- Each item is scored 0 to 4. Part IA runs 0 to 24, Part IB runs 0 to 28, and Part I as a whole runs 0 to 52.
- Covers the non-motor side of Parkinson's. Part IA rates thinking, hallucinations and psychosis, mood, apathy, and features of dopamine dysregulation. Part IB rates sleep, daytime sleepiness, pain, urinary problems, constipation, light-headedness on standing, and fatigue.
- Published by the International Parkinson and Movement Disorder Society.
Psychometrics
Cronbach's alpha for the Part I total, from the original clinimetric study and from the independent Part I validation. Higher is better.
What does MDS-UPDRS Part I measure?
Part I covers the non-motor side of Parkinson’s disease, the symptoms that are not movement problems and are often the ones that go unrecorded. It comes in two blocks with different reporters. Part IA, items 1.1 to 1.6, is rated by the investigator and covers cognitive impairment, hallucinations and psychosis, depressed mood, anxious mood, apathy, and features of dopamine dysregulation. Part IB, items 1.7 to 1.13, is completed by the person and covers sleep problems, daytime sleepiness, pain and other sensations, urinary problems, constipation, light-headedness on standing, and fatigue.
The scale is licensed, so this page describes what Part I covers rather than reproducing its wording. The official form, with the exact question text and the rating anchors, comes from the International Parkinson and Movement Disorder Society at movementdisorders.org.
What does an MDS-UPDRS Part I score mean?
Higher means more non-motor burden. A 2015 study of 452 people with Parkinson’s proposed three bands for the Part I total.
| Part I total | Severity |
|---|---|
| 0 to 10 | Mild |
| 11 to 21 | Moderate |
| 22 and above | Severe |
The band is reference information for the care team, tracked over time rather than read once. One limit is worth stating plainly. Part I is a wide net over very different symptoms, so the same total can come from bad sleep and fatigue in one person and from hallucinations in another. The item pattern matters more than the total, which is why clinicians look at where the points came from before they act on the number.
How MDS-UPDRS Part I is administered
- Administered by
- Part IA by the investigator, using information from the person and their carers. Part IB by the person, with or without a carer's help, independently of the investigator.
- Time to administer
- About 30 minutes for all four parts. No separate published figure for Part I.
- Equipment
- Pen and paper
- Cost
- Free to take here.
- Published by
- International Parkinson and Movement Disorder Society
- Permission
- Required for each use, through the permission request form at movementdisorders.org
- Training required
- The Movement Disorder Society runs a certificate program for raters
- Age range
- Adults
- Available languages
- Official translations in more than 25 languages
Which conditions is MDS-UPDRS Part I used for?
Related instruments
- MDS-UPDRS Part IIThe other half of daily living, covering how motor symptoms land on everyday tasks
- MDS-UPDRS Part IIIThe clinician's motor examination, the part most often quoted alone in trials
- Montreal Cognitive Assessment (MoCA)Cognition in more depth than Part I's single item on thinking
- Parkinson's Disease Questionnaire (PDQ-39)Quality of life across eight areas, including mood and cognition
MDS-UPDRS Part I questions, answered
How is MDS-UPDRS Part I scored?
Every item is rated 0 to 4, where 0 is normal and 4 is severe, and the 13 item scores are added. Part IA, the six items the investigator rates, runs from 0 to 24. Part IB, the seven items the person completes, runs from 0 to 28. Part I as a whole runs from 0 to 52. It is not folded into a total with the other three parts.
What is a normal MDS-UPDRS Part I score?
There is no separate normal range published for people without Parkinson's. Within Parkinson's, 0 means no reported non-motor burden and up to 10 falls in the mild band. Scores at the very bottom are uncommon. In a validation study of 94 people with Parkinson's, only 2% scored 0, and nobody scored the maximum.
Who completes MDS-UPDRS Part I?
Both the clinician and the person. Part IA is assessed by the investigator using everything relevant from the person and their carers. Part IB is completed by the person, with or without a carer's help, but independently of the investigator. That split is why Part I can be started before the visit but not finished there and then.
How long does MDS-UPDRS Part I take?
The Movement Disorder Society and the reference databases publish a time for the full four-part scale, about 30 minutes, rather than a figure for Part I on its own. In practice Part IB is a short questionnaire and Part IA is folded into the consultation.
Is MDS-UPDRS Part I free?
Yes. It is free to take here. The scale itself is published by the International Parkinson and Movement Disorder Society, which is who to approach about administering it in your own practice.
Does MDS-UPDRS Part I diagnose Parkinson's disease?
No. It quantifies non-motor symptoms and produces reference information for the care team. Diagnosis stays with your clinician.
Evidence, psychometrics and provenance
Part I is one of the four parts of the MDS-UPDRS, published in 2008 by Goetz and colleagues for the International Parkinson and Movement Disorder Society. It was validated on its own four years later, in 94 people with Parkinson’s spanning Hoehn and Yahr stages I to V, against a battery of established non-motor scales.
- Agreement with the original UPDRS Part I
- r 0.81 (Gallagher et al., 2012)
- Convergent validity
- r 0.89 against a composite of validated non-motor scales (Gallagher et al., 2012)
- Floor and ceiling effects
- 2% floor, 0% ceiling in 94 people (Gallagher et al., 2012)
- Test-retest reliability
- ICC above 0.85 for each part's total (Martinez-Martin et al., 2013)
References
- 1.Goetz CG, Tilley BC, Shaftman SR, et al. Movement Disorder Society-sponsored revision of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS): scale presentation and clinimetric testing results. Mov Disord. 2008;23(15):2129-2170.
- 2.Gallagher DA, Goetz CG, Stebbins G, Lees AJ, Schrag A. Validation of the MDS-UPDRS Part I for nonmotor symptoms in Parkinson's disease. Mov Disord. 2012;27(1):79-83.
- 3.Martinez-Martin P, Rodriguez-Blazquez C, Alvarez-Sanchez M, et al. Expanded and independent validation of the Movement Disorder Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS). J Neurol. 2013;260(1):228-236.
- 4.Martinez-Martin P, Rodriguez-Blazquez C, Alvarez M, et al. Parkinson's disease severity levels and MDS-Unified Parkinson's Disease Rating Scale. Parkinsonism Relat Disord. 2015;21(1):50-54.
- 5.Zou H, Goetz CG, Stebbins GT, Mestre TA, Luo S. Increasing sensitivity in patient-reported MDS-UPDRS items for predicting medication initiation in early PD. Mov Disord Clin Pract. 2025;12(2):148-156. (Source for the Part IA and Part IB item ranges.)
- 6.International Parkinson and Movement Disorder Society. MDS-UPDRS: rating scale, permission request form, translations, and rater certificate program. movementdisorders.org.
- 7.Shirley Ryan AbilityLab. Rehabilitation Measures Database: MDS-UPDRS. Administration, cost, and the Part IA and Part IB split.
This assessment uses a validated instrument and is reference information, not a diagnosis. The MDS-UPDRS is copyright the International Parkinson and Movement Disorder Society. This page describes the scale and does not reproduce it. Permission for each use is requested at movementdisorders.org.