Background

Despite the established importance of identifying depression in Parkinson's disease, our understanding of the factors which place the Parkinson's disease patient at future risk of depression is limited.

Methods

Our sample consisted of 874 patients from two longitudinal cohorts, PPMI and PDBP, with median follow-up durations of 7 and 3 years respectively. Risk factors for depressive symptoms at baseline were determined using logistic regression. A Cox regression model was then used to identify baseline factors that predisposed the non-depressed patient to develop depressive symptoms that were sustained for at least one year, while adjusting for antidepressant use and cognitive impairment. Common predictors between the two cohorts were identified with a random-effects meta-analysis.

Results

We found in our analyses that the majority of baseline non-depressed patients would develop sustained depressive symptoms at least once during the course of the study. Probable REM sleep behavior disorder (pRBD), age, duration of diagnosis, impairment in daily activities, mild constipation, and antidepressant use were among the baseline risk factors for depression in either cohort. Our Cox regression model indicated that pRBD, impairment in daily activities, hyposmia, and mild constipation could serve as longitudinal predictors of sustained depressive symptoms.

Conclusions

We identified several potential risk factors to aid physicians in the early detection of depression in Parkinson's disease patients. Our findings also underline the importance of adjusting for multiple covariates when analyzing risk factors for depression.

中文翻译：

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帕金森病抑郁症状发展的纵向危险因素

背景

尽管识别帕金森病患者的抑郁症具有公认的重要性，但我们对将帕金森病患者置于未来患抑郁症风险的因素的理解是有限的。

方法

我们的样本包括来自两个纵向队列 PPMI 和 PDBP 的 874 名患者，中位随访时间分别为 7 年和 3 年。使用逻辑回归确定基线时抑郁症状的危险因素。然后使用 Cox 回归模型来确定使非抑郁患者易患抑郁症状并持续至少一年的基线因素，同时针对抗抑郁药的使用和认知障碍进行调整。通过随机效应荟萃分析确定了两个队列之间的共同预测因子。

结果

我们在分析中发现，大多数基线非抑郁患者在研究过程中至少会出现一次持续的抑郁症状。可能的 REM 睡眠行为障碍 (pRBD)、年龄、诊断持续时间、日常活动障碍、轻度便秘和使用抗抑郁药是两个队列中抑郁症的基线危险因素。我们的 Cox 回归模型表明，pRBD、日常活动障碍、嗅觉减退和轻度便秘可以作为持续抑郁症状的纵向预测因子。

结论

我们确定了几个潜在的风险因素，以帮助医生及早发现帕金森病患者的抑郁症。我们的研究结果还强调了在分析抑郁症风险因素时调整多个协变量的重要性。