Depression increases in patients with Parkinson?s disease according to the increasing severity of the cognitive impairment

Abstract

Objective: To test the hypothesis that severity of cognitive impairment modifies the association between depression and Parkinson's disease (PD). Method: One-phase population-based door-to-door surveys. This is a secondary analysis of 1,451 people aged 65 years and older with cognitive impairment living in defined catchment areas. Depression was estimated according to ICD-10, self-reported PD, disability according to WHODAS-II and cognitive status according to the CSI-D. Results: The mean age of the sample was 79.3 years old and most (69%) were women. Of the total sample, 16.1% had depression and it was significantly higher among participants with PD. There was an increase on the ORs of the association between depression and PD with decreased scores in the cognitive test (Adjusted OR from 0.98 to 8.04). Conclusion: The association between depression and PD increases with the severity of the cognitive impairment.Keywords: parkinsonism, depression, cognitive impairment, Parkinson's disease. RESUMOObjetivo: Testar a hipótese que a gravidade do prejuízo cognitivo modifica a associação entre depressão e doença de Parkinson (DP). Método: Estudo populacional através da análise secundária de 1.451 pessoas com idade maior ou igual a 65 anos com prejuízo cognitivo que residiam em áreas de abrangência definidas. A depressão foi estimada de acordo com a CID-10, auto-relato de DP, incapacidade conforme a WHODAS-II e nível cognitvo de acordo com a CSI-D. Resultado: A média de idade foi 79,3 anos, predominaram as mulheres (69%). Do total de indivíduos, 16,1% tinham depressão, significantemente maior entre os participantes com DP. Houve aumento gradativo na OR relativa à associação entre depressão e DP com a diminuição do escore no teste cognitivo (OR ajustado variou de 0,98 a 8,04). Conclusão: A associação entre depressão e DP parece aumentar com a gravidade do prejuízo cognitivo.Palavras-chave: parkinsonismo, depressão, prejuízo cognitivo, doença de Parkinson.Depression and dementia are common non-motor manifestations of Parkinson's disease (PD). Prevalence estimates vary widely, but most studies have suggested that 40% to 50% of PD patients present clinically relevant depression 1, 2 and 30% of them present dementia 3 .Cognitive impairment itself increases the risk of depression 4 and thus it is plausible that the presence of cognitive impairment might influence the association of depression with PD. Most studies investigating the association of depression and PD are based on convenience clinical samples and

Variants in SNCA Gene Are Associated with Parkinson’s Disease Risk and Cognitive Symptoms in a Brazilian Sample

“…Studies show higher prevalence of cognitive deficits and depression in PD (Reijnders et al, 2009; Kehagia et al, 2010) and there is a clinical association between the two kinds of symptoms (Chagas et al, 2014). Our PD sample presented moderate motor impairment, higher prevalence of anxiety and depression symptoms and a similar frequency of cognitive impairment compared to control group.…”

The daily lives of people with Parkinson's disease

“…In addition, there is a strong interaction between PD and depression. A study conducted in seven different countries found a significant association between both, with about onethird of people having Parkinson's disease and also depression (5) , a condition that needs special attention on the part of health professionals, in particular nurses.…”

“…In addition, there is a strong interaction between PD and depression. A study conducted in seven different countries found a significant association between both, with about onethird of people having Parkinson's disease and also depression (5) , a condition that needs special attention on the part of health professionals, in particular nurses.Another relevant aspect concerns the individuality of people with the disease, because the meanings of the different motor and non-motor symptoms influence specifically each individual. Getting to know the reality of these people is fundamental to the understanding of the role of nurses in the care to the disease, since it is a condition that affects the motor system, the psychological aspect, the interaction with the family and society.…”

Sintomas De Depressão Em Pacientes Com Declínio Cognitivo Leve Na Doença De Parkinson

“…(3) × (dp) 8,7 (0,98) 8,5 (1,12) 9,0 (1,39) 8,6 (0,96) > 0,05 M5 (4) × (dp) 7,4 (1,97) 7,00 (1,51) 8,7 (1,08) 7,9 (1,46) < 0,05 Reconhecimento × (dp) 10,0 (0,17) 9,7 (0,46) 10,0 (0,00) 10,0 (0,25) < 0,05 TDR × (dp) 7,2 (2,41) 7,4 (2,26) 7,3 (1,88) 7,0 (2,07) >0,05 FVS × (dp) 17,3 (3,45) 16,1 (4,95) 17,2 (4,31) 15,7 (3,74) >0,05 RAVLT A1 (5) ) × (dp) 4,5 (1,28) 4,1 (0,83) 5,2 (1,71) 4,9 (1,46) > 0,05 B1 (6) × (dp) 4,8 (1,55) 3,7 (1,40) 4,8 (2,11) 4,5 (2,37) > 0,05 A6 (7) × (dp) 5,8 (3,25) 5,0 (3,03) 7,8 (2,9) 6,8 (2,77) < 0,05 A7 (8) × (dp) 6,3 (3,43) 5,0 (2,93) 8,5 (3,18) 6,4 (3,05) < 0,05 LOT (9) × (dp) 15,9 (8,16) 13,9 (5,71) 17,2 (5,95) 15,4 (4,41) > 0,05 ITP (10) × (dp) 1,3 (0,95) 0,9 (0,46) 1,0 (0,47) 1,0 (0,52) > 0,05 ITR (11) × (dp) 0,6 (0,26) 0,6 (0,29) 0,8 (0,22) 0,7 (0,25) < 0,05 VE (12) × (dp) 1,1 (0,72) 1,4 (1,84) 1,1 (0,28) 1,1 (0,47) > 0,05 Reconhecimento × (dp) 7,9 (3,97) 4,5 (5,43) 8,4 (4,32) 4,1 (5,44) < 0,05 Dígitos OD (13) × (dp) 6,9 (2,53) 7,5 (2,03) 6,2 (1,36) 6,7 (1,18) > 0,05 OI (14) × (dp) 4,7 (1,94) 4,9 (1,41) 4,1 (1,57) 3,8 (1,57) > 0,05 OD-OI (15) × (dp) 2,2 (1,72) 2,6 (1,88) 2,0 (1,44) 2,3 (1,82) > 0,05 Stroop Tempo 1 (16) × (dp) 19,9 (7,24) 21,2 (14,41) 17,1 (3,59) 20,2 (6,32) > 0,05 Erros 1 (17) × (dp) 0,0 (0,00) 0,1 (0,26) 0,0 (0,19) 0,2 (0,75) > 0,05 Te...…”

“…They correlated depressive symptoms with cognitive impairment and motor disorders, suggesting that endogenous changes in the neurotransmitter system, besides the natural progression of the disease, would contribute to the onset of depressive symptoms. Similarly, Chagas et al (13) investigated the association between depression and PD, and concluded that this association is stronger for those with cognitive deficits. The comorbidity between PD and depression becomes larger with increasing cognitive impairment, suggesting a two-way mechanism, where depression and cognition are mutually influenced.…”