Abstract
BackgroundTo evaluate the association between Parkinson’s disease (PD) prognosis and the patient’s onset of depression.MethodsA total of 353 patients with newly-diagnosed PD and a history of depression were enrolled. On the basis of the onset of depression before or after PD diagnosis, we divided participants into PD patients with pre- or post-diagnostic depression. Cox’s regression analysis was used to detect risks between the onset of depression and outcomes (including death, accidental injury, dementia, and aspiration pneumonia). The association between the onset of depression and levodopa equivalent dosage (LED) and cumulative equivalent dosage of antidepressants were assessed.ResultsPD patients with post-diagnostic depression were associated with significantly higher risks of dementia (adjusted HR = 2·01, p = 0·015), and were older (58·5 ± 17·7 vs. 53·7 ± 18·6, p = 0·020) at the time of PD diagnosis than PD patients with pre-diagnostic depression. The higher incident rate of accidental injury was also noted in PD patients with post-diagnostic depression (48·1 vs. 31·3/1000 person-years, HR = 1·60, p = 0·041), but no statistical significance was observed in the adjusted hazard ratio (HR) (HR = 1·52, p = 0·069). Otherwise, mortality, motor condition and severity of depression revealed no significant difference between PD patients with pre-diagnostic and post-diagnostic depression.ConclusionPD patients with post-diagnostic depression had higher incidence of dementia, implying different onset time of depression could be associated with different subtypes and spreading routes which should be examined in follow-up studies.
Highlights
Parkinson’s disease (PD) is currently considered to be a highly heterogeneous, multisystem disorder with motor and nonmotor symptoms (NMS)
PD patients with post-diagnostic depression were associated with significantly higher risks of dementia, and were older (58Á5 ± 17Á7 vs. 53Á7 ± 18Á6, p = 0Á020) at the time of PD diagnosis than PD patients with pre-diagnostic depression
The higher incident rate of accidental injury was noted in PD patients with post-diagnostic depression (48Á1 vs. 31Á3/1000 person-years, HR = 1Á60, p = 0Á041), but no statistical significance was observed in the adjusted hazard ratio (HR) (HR = 1Á52, p = 0Á069)
Summary
Parkinson’s disease (PD) is currently considered to be a highly heterogeneous, multisystem disorder with motor and nonmotor symptoms (NMS). Many recently published articles have described NMS-dominant phenotypes such as cognitive impairment, apathy, depression or anxiety, sleep disorder, olfactory loss, and dysautonomia. These reported NMS-dominated subtypes are consistent with the neuropathological studies, that suggesting differential pathways of neuronal degeneration and Lewy body deposition in the nondopaminergic brainstem and limbic areas of PD [1]. Five patients died of bronchopneumonia, with one patient dying of complications related to a hip fracture [5].The independent predictors of mortality included higher age, male sex, severity of motor symptoms, gait dysfunction, dementia, the presence of psychotic symptoms and depression [6].
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
