Factors associated with depression in patients with Parkinson's disease A multicenter study in Lima, Peru.

Nilton Custodio,Rosa Montesinos,Cristian Morán-Mariños,Yadira Bardales,Eder Herrera-Pérez,Koni Mejía-Rojas,Carlos Alva-Diaz,Sheila Castro-Suárez,David Lira

doi:10.1590/1980-57642018dn12-030010

Abstract

The diagnosis and treatment of depression in patients with Parkinson’s disease (PD) is inadequate, often contributing to a reduced quality of life, rapid disease progression, higher cognitive impairment, and an increased burden of care for family members of patients with PD.Objective:To determine the factors associated with depression in PD and to examine the frequency of depressive symptoms among patients with PD.Methods:This study was an observational, analytical, multicenter study of a cross-sectional cohort, conducted between July 2016 and May 2017. PD patients were recruited from neurology clinics in Lima, Peru. All statistical analyses were performed using descriptive statistics. Bivariate and multivariate logistic regression analyses were calculated using STATA.Results:Out of 124 patients (average age: 68.7 years; 58% males) included in the study 60.5% (75/124) presented with symptoms of depression; only 20% (25/124) received antidepressants. Factors associated with depression in PD included: unemployment, falls, freezing of gait, involuntary movements micrographia, stooped posture, hyposmia, movement disorders in sleep, rapid disease progression, and the use of MAOIs. Furthermore, statistically significant differences were found in disease duration, UPDRS and MMSE scores, Hoehn and Yahr (HY) stage, and length of time taking L-dopa between PD patients with and without depressive symptoms.Conclusion:Factors associated with depressive symptoms in patients with PD were hyposmia, rapid progression of the disease, the use of L-dopa, and use of MAOIs. The frequency of depressive symptoms in patients with PD is high; early diagnosis and prompt treatment are needed to improve their quality of life and the family environment.

Highlights

The diagnosis and treatment of depression in patients with Parkinson’s disease (PD) is inadequate, often contributing to a reduced quality of life, rapid disease progression, higher cognitive impairment, and an increased burden of care for family members of patients with PD
Exclusion criteria consisted of: a diagnosis of PD with a level of cognitive impairment that precluded the application of Beck’s Depression Inventory (BDI-II); a Mini-Mental State Examination (MMSE) score of less than 25.23 Data collection was carried out using a structured interview where data on sociodemographic variables were collected including age, gender, level of education completed, place of origin, and race; clinical factors such as age at onset of PD, time of disease progression, clinical features of PD, symptoms of PD, the presence of non-motor symptoms in PD, rapid progression of PD motor symptoms, the United Parkinson’s Disease Rating Scale (UPDRS) and MMSE scores, Hoehn and Yahr (HY) stage; and pharmacological factors, such as the type of medication used
This study found that the frequency of symptoms of depression in patients with PD was 60.9%, similar to that reported in other investigations: 54% in the study carried out by Pinto et al.,22 50% in the study of SerranoDueñas,[21] and 48.8-50.1% as reported by Chaudhuri et al.[25]