The impact of depression on survival of Parkinson's disease patients: a five-year study

Abstract

Objective: The aim of this study is to evaluate the survival rate in a cohort of Parkinson's disease patients with and without depression. Methods: A total of 53 Parkinson's disease subjects were followed up from 2003-2008 and 21 were diagnosed as depressed. Mean time of follow up was 3.8 (SD 95% = 1.5) years for all the sample and there was no significant difference in mean time of follow up between depressed and nondepressed Parkinson's disease patients. Survival curves rates were fitted using the Kaplan-Meier method. In order to compare survival probabilities according to the selected covariables the Log-Rank test was used. Multivariate analysis with Cox regression was performed aiming at estimating the effect of predictive covariables on the survival. results: The cumulative global survival of this sample was 83% with nine deaths at the end of the study -five in the depressed and four in the nondepressed group, and 55.6% died in the first year of observation, and none died at the fourth and fifth year of follow up. conclusion: Our finding point toward incremental death risk in depressed Parkinson's disease patients. reSUMOObjetivo: O objetivo deste estudo é avaliar a taxa de mortalidade em uma coorte de parkinsonianos com e sem depressão. Métodos: O total de 53 pacientes com doença de Parkinson foi acompanhado de 2003 a 2008, e 21 deles foram avaliados com depressão. O tempo médio de doença foi de 3,8 (DP 95% = 1,5) anos para toda a amostra e não houve diferença significativa entre os parkinsonianos, com e sem depressão, acompanhados durante esse período. Curvas de sobrevida foram obtidas utilizando-se o método de Kaplan-Meier. A fim de comparar as probabilidades de sobrevivência de acordo com as covariáveis selecionadas, o teste Log-Rank foi usado. A análise multivariada com regressão de Cox foi realizada com o objetivo de estimar o efeito de covariáveis preditivas sobre a sobrevivência. resultados: A sobrevivência global acumulada dessa amostra foi de 83%, com nove mortes no final do estudo -cinco no grupo com depressão e quatro no grupo sem depressão. Além disso, 55,6% morreram durante o primeiro ano de observação, e nenhum morreu no quarto e quinto ano de acompanhamento. conclusão: Nossos achados indicam um incremento no risco de morte em pacientes com doença de Parkinson e depressão.

The impact of psychiatric comorbidity on Parkinson's disease outcomes: a systematic review and meta-analysis

“…The association of depression with subsequent cognitive impairment, disease progression, death, disability, falls or fractures and residential home admission was tested across 6324 participants in 29 studies. 18 , 19 , 20 , 21 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 Depression was significantly associated with cognitive impairment (SMD 0.37 [95% CI 0.10–0.65], p = 0.0085, I 2 27.1%, [ I 2 95% CI 0–35.0]), disease progression (SMD 0.46 [95% CI 0.18–0.74], p = 0.0011, I 2 52.2 [ I 2 95% CI 0–81.1]), and disability (SMD 0.42 [95% CI 0.25–0.60], p = <0.0001, I 2 7.9%, [ I 2 95% CI 0–91.2]). There was no significant association for falls or fractures (SMD −0.28 [95% CI −0.90 to 0.34], p = 0.37, I 2 0%, [ I 2 95% CI 0–99.5]) and death (SMD 0.32 [95% CI −0.56 to 1.20], p = 0.47, I 2 0% [ I 2 95% CI 0–37.0]).…”

Genetic Determinants of Survival in Parkinson's Disease in the Asian Population

“…In this context, we built a predictive model combining informative clinical traits and PRS of survival of PD, which substantially improved the prediction accuracy. The seven filtered clinical variables have been identified as associated with the survival of PD by previous clinical studies, comprising sex, 8 AAO, 40 LEDD, 41 HAMD, 42 HAMA, 43 MoCA, 8 and HY 44 . Compared with each clinical factor, PRS of survival of PD could still improve the survival predictability.…”

Neuropsychological profile of Parkinson's disease patients selected for deep brain stimulation surgery

“…In addition to improving the cardinal motor symptoms of PD, DBS surgery reduces the complications that accompany dopaminergic therapies, such as motor fluctuations and dyskinesia. 3 , 4 Indication is thorough and includes an established PD diagnosis for at least five years; absence of severe cognitive impairment or dementia; absence of other comorbidities; and response to preoperative levodopa, which is considered a good prognosis for postoperative outcomes. 5 , 6…”