Danny Bega1, Sheng Luo2, Hubert Fernandez3, Kelvin Chou4, Michael Aminoff5, Sotirios Parashos6, Harrison Walker7, David S Russell8, Chadwick W Christine5, Rohit Dhall9, Carlos Singer10, Ivan Bodis-Wollner11, Robert Hamill12, Daniel Truong13, Zoltan Mari14, Sofya Glazmann11, Meilin Huang2, Emily Houston12, Tanya Simuni1. 1. Northwestern University, Chicago, Illinois, USA. 2. University of Texas Health Science Center, Houston, Texas, USA. 3. Cleveland Clinic, Cleveland, Ohio, USA. 4. University of Michigan, Ann Arbor, Michigan, USA. 5. University of California San Francisco, San Francisco, California, USA. 6. Minneapolis Clinic, Minneapolis, Minnesota, USA. 7. University of Alabama at Birmingham, Birmingham, Alabama, USA. 8. Institute for Neurodegenerative Disorders, New Haven, Connecticut, USA. 9. Muhammad Ali Parkinson Center, Phoenix, Arizona, USA. 10. University of Miami, Miami, Florida, USA. 11. State University of New York, Syracuse, New York, USA. 12. University of Vermont, Burlington, Vermont, USA. 13. Parkinson and Movement Disorders Institute, Fountain Valley, California, USA. 14. Johns Hopkins University, Baltimore, Maryland, USA.
Abstract
BACKGROUND: Depression is one of the most common nonmotor symptoms associated with Parkinson's disease (PD), yet the impact of depression on progression of disease is unclear. OBJECTIVE: The aim of this study was to prospectively characterize the relationship between depressive symptoms and measures of disease progression in a large sample of patients with early, medically treated PD. METHODS: Baseline and longitudinal Beck Depression Inventory (BDI) scores from participants in the NINDS Exploratory Trials in PD Long Term Study 1 were correlated with changes in multiple measures of disease severity over 5 years. Multivariate analysis of predictors of change in BDI was performed. RESULTS: Of 1,741 participants, 746 completed 5-year assessments and were included. Mean age was 62.00 years (standard deviation [SD]: 9.22) and mean disease duration was 1.69 years (SD, 1.16). Mean BDI score was 6.24 (SD, 5.02) at baseline and 8.57 (SD, 6.60) at 5 years. Baseline BDI score was strongly associated with rate of change in all examined measures of disease severity. In multivariate analysis, BDI 5-year change was associated with change in UPDRS Part I (excluding depression item; P < 0.01), 33-item Parkinson's Disease Questionnaire (P < 0.01), EuroQOL Five Dimensional Questionnaire (P = 0.02), and Total Functional Capacity (P < 0.01), but was not associated with motor or cognitive measures. This model explained 68.8% of the variance 5-year change of the BDI score. CONCLUSIONS: Worse baseline BDI scores are associated with a decline in multiple measures of disease severity in PD. Worsening of BDI at 5 years was associated with worsening in UPDRS Part I and quality-of-life measures, but not with motor or cognitive measures.
BACKGROUND:Depression is one of the most common nonmotor symptoms associated with Parkinson's disease (PD), yet the impact of depression on progression of disease is unclear. OBJECTIVE: The aim of this study was to prospectively characterize the relationship between depressive symptoms and measures of disease progression in a large sample of patients with early, medically treated PD. METHODS: Baseline and longitudinal Beck Depression Inventory (BDI) scores from participants in the NINDS Exploratory Trials in PD Long Term Study 1 were correlated with changes in multiple measures of disease severity over 5 years. Multivariate analysis of predictors of change in BDI was performed. RESULTS: Of 1,741 participants, 746 completed 5-year assessments and were included. Mean age was 62.00 years (standard deviation [SD]: 9.22) and mean disease duration was 1.69 years (SD, 1.16). Mean BDI score was 6.24 (SD, 5.02) at baseline and 8.57 (SD, 6.60) at 5 years. Baseline BDI score was strongly associated with rate of change in all examined measures of disease severity. In multivariate analysis, BDI 5-year change was associated with change in UPDRS Part I (excluding depression item; P < 0.01), 33-item Parkinson's Disease Questionnaire (P < 0.01), EuroQOL Five Dimensional Questionnaire (P = 0.02), and Total Functional Capacity (P < 0.01), but was not associated with motor or cognitive measures. This model explained 68.8% of the variance 5-year change of the BDI score. CONCLUSIONS: Worse baseline BDI scores are associated with a decline in multiple measures of disease severity in PD. Worsening of BDI at 5 years was associated with worsening in UPDRS Part I and quality-of-life measures, but not with motor or cognitive measures.
Authors: Nadeeka N W Dissanayaka; Anna Sellbach; Peter A Silburn; John D O'Sullivan; Rodney Marsh; George D Mellick Journal: J Affect Disord Date: 2011-02-26 Impact factor: 4.839
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