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Objective: To examine the relative risk of depression among patients with amyotrophic lateral sclerosis (ALS), both in terms of depression diagnosis and use of antidepressant drugs, before and after diagnosis. Methods:We conducted a nested case-control study including 1,752 patients with ALS diagnosed from July 2005 to December 2010 and 8,760 controls based on the Swedish national health and population registers, to assess the associations of depression diagnosis and use of antidepressant drugs with a subsequent risk of ALS. We further followed the patients with ALS after diagnosis to estimate the association of an ALS diagnosis with the subsequent risk of depression and use of antidepressant drugs.Results: Before diagnosis, patients with ALS were at higher risk of receiving a clinical diagnosis of depression compared to controls (odds ratio [OR] 1.7, 95% confidence interval [CI] 1.3-2.3), and the highest risk increase was noted during the year before diagnosis (OR 3.5, 95% CI 2.1-5.6). Patients with ALS also had a highly increased risk of depression within the first year after diagnosis (hazard ratio 7.9, 95% CI 4.4-14.3). Antidepressant use was more common in patients with ALS than in controls, especially during the year before (OR 5.8, 95% CI 4.5-7.5) and the year after (hazard ratio 16.1, 95% CI 11.5-22.6) diagnosis. Approximately 30% of patients with amyotrophic lateral sclerosis (ALS) show mild cognitive impairment and 15% present with overt frontotemporal dementia (FTD). Conclusions:1,2 The overlap between ALS and FTD presents a continuum of symptoms such as memory impairment, apathy, and behavioral changes, 3,4 many of which mimic the typical symptoms of depression. 5The strong emotions evoked by receiving a serious diagnosis such as ALS may also lead to increased risk of mental illnesses, including depression. Multiple studies have shown that patients with ALS are more likely to develop depression than ALS-free individuals, although the reported prevalence of depression varies greatly.6-13 Different measurements of depression together with the varying representativeness of the patient samples used in previous studies may partly explain the different prevalences reported so far.The aim of the present study was to investigate the occurrence of depression diagnosis and use of antidepressants before and after ALS diagnosis in a nationwide sample of patients with ALS, using a matched random sample of the Swedish population as the reference.

ObjectiveCauses of Parkinson disease are largely unknown, but recent evidence suggests associations with physical activity and anthropometric measures.MethodsWe prospectively analyzed a cohort of 41,638 Swedish men and women by detailed assessment of lifestyle factors at baseline in 1997. Complete follow-up until 2010 was achieved through linkage to population-based registers. We used multivariable Cox proportional hazards models to estimate hazard ratios with 95% confidence intervals (CIs).ResultsWe identified 286 incident cases of Parkinson disease during follow-up. Multivariable adjusted hazard ratios were 1.06 (95% CI 0.76–1.47) for sitting time ≥6 vs <6 hours per day; and 1.13 (95% CI 0.60–2.12) for body mass index ≥30 vs <25 kg/m2. Results did not differ by sex.ConclusionsNo association between prolonged sitting time per day or obesity and risk of Parkinson disease was found.