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

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.

Falls in patients with Parkinson’s disease from China: A Cross-sectional Study

“…Although we don't know the internal correlates between fall and mood disorder, we've identified the amygdala and parahippocampal gyrus play a key role in mood disorder in patients with PD, depression was positively correlated with the parahippocampal gyrus [13]. Despite we've highlighted the importance of non-motor symptom, still most depression patients underestimated and more than 80% didn't receive anti-depression therapy [14]. Therefore, we shouldn't only focus on the physiological conditions of patients, some emotional symptoms are also important.…”

Olfactory Dysfunction and Its Relationship With Clinical Features of Parkinson's Disease

“…Comparing the clinical features of the PD-OD and PD-NOD groups, we find that the PD-OD and PD-NOD groups are significantly different in terms of mood, which could be concluded from the domain 3 score of the NMSS and the Hamilton Depression Scale score. Many studies show that patients who lose their sense of smell are more likely to have depression, and there is a close relationship between olfactory dysfunction and depression, which may be related to the fact that the olfactory conduction pathway affects the serotonin system in the body and emotional centers, such as the hippocampus and amygdala ( 29 – 31 ). However, when we conduct multivariate logistic regression analysis, we do not find an association between depression and olfactory dysfunction.…”

Suporte social e enfrentamento de pacientes com Doença de Parkinson e seus cuidadores familiares

“…A depressão é um dos sintomas mais graves da DP e é desencadeada por uma carência de dopamina no organismo e, quando associada a outros fatores, tende a se intensificar. A depressão atinge cerca de 40% a 60% dos portadores da DP em alguma fase da doença (Barreto & Fermoseli, 2017;Cetolin et al, 2012;Custodio et al, 2018;Faria, Lima, & Pereira-Silva, 2019;Patto & Freitas, 2012;Navarro-Peternella & Marcon, 2009). Estudos realizados mostraram que a depressão antecede os sintomas motores da Doença de Parkinson em 25% dos pacientes.…”

“…Estudos realizados mostraram que a depressão antecede os sintomas motores da Doença de Parkinson em 25% dos pacientes. Ademais, verificou-se a presença de sintomas depressivos em 70% dos portadores da DP, que pode estar associado ao avanço da doença, uma vez que há uma tendência ao agravo no quadro dos sintomas, interferindo diretamente na qualidade de vida dos indivíduos (Custodio et al, 2018;Faria et al, 2019;Navarro-Peternella & Marcon, 2009). A tendência ao isolamento social, também muito referida na bibliografia e citada nas entrevistas, está relacionada ao maior comprometimento físico, o qual pode estar ou não, acompanhando de perdas cognitivas.…”