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

Burchill, Ella; Watson, Cameron James; Fanshawe, Jack B.; Badenoch, James Brunton; Rengasamy, Emma; Ghanem, Dory Anthony; Holle, Constantine; Conti, Isabella; Sadeq, Mohammed Ahmed; Saini, Aman; Lahmar, Abdelilah; Cross, Ben; McGuigan, Gareth; Nandrha, Amar; Kane, Edward J.; Wozniak, Julia; Farouk Ghorab, Reem Mohamed; Song, Jia; Sommerlad, Andrew; Lees, Andrew; Zandi, Michael S.; David, Anthony S.; Lewis, Glyn; Carter, Ben; Rogers, Jonathan P.

doi:10.1016/j.lanepe.2024.100870

Cited by 4 publications

(1 citation statement)

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“…7 8 Depression has a substantial impact on people with PD and, in some patients, is the largest determinant of quality of life. 9 There is some evidence to suggest that depression is associated with poorer PD prognosis 10 including neurological outcomes (eg, motor severity), 11 disability, 12 cognitive decline 13 and death. 14 However, the temporal relationship between depression in PD and the effect this has on disease prognosis has not been comprehensively evaluated in a large longitudinal cohort study.…”

Section: Introductionmentioning

confidence: 99%

Neuroanatomical and prognostic associations of depression in Parkinson’s disease

Badenoch,

Paris,

Jacobs

et al. 2024

J Neurol Neurosurg Psychiatry

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BackgroundDepression is reported as a risk factor, prodromal feature and late consequence of Parkinson’s disease (PD). We aimed to evaluate the timing, neuroanatomy and prognostic implications of depression in PD.MethodsWe used data from 434 023 participants from UK Biobank with 14.1 years of follow-up. Multivariable regression models established associations of depression with incident PD and regional brain volumes. Cox proportional hazards models assessed prognostic associations of depression in PD with incident dementia and all-cause mortality.ResultsOf 2632 individuals with incident PD, 539 (20.5%) were diagnosed with depression at some point. Depression was associated with an increased risk of subsequent PD (risk ratio 1.53, 95% CI 1.37 to 1.72). Among incident PD cases, depression prevalence rose progressively from 10 years pre-PD diagnosis (OR 2.10, 95% CI 1.57 to 2.83) to 10 years postdiagnosis (OR 3.51, 95% CI 1.33 to 9.22). Depression severity in PD was associated with reduced grey matter volume in structures including the thalamus and amygdala. Depression prior to PD diagnosis increased risk of dementia (HR 1.47, 95% CI 1.05 to 2.07) and mortality (HR 1.30, 95% CI 1.07 to 1.58).ConclusionsThis large-scale prospective study demonstrated that depression prevalence increases from 10 years before PD diagnosis and is a marker of cortical and subcortical volume loss. Depression before PD diagnosis signals a worse prognosis in terms of dementia and mortality. This has clinical implications in stratifying people with poorer cognitive and prognostic trajectory in PD.

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