Depressive symptoms before and after Parkinson’s diagnosis—A longitudinal analysis

Abstract

Background Depression is common in Parkinson’s disease (PD). It is however unclear when and how depressive symptoms develop and progress in the course of PD development. Objective To assess how depressive symptoms evolve in PD, using repeated measures. Methods In 2994 older adults, ages 70–79 years, depressive symptoms were assessed 8 times over 11 years using the 10-item Center for Epidemiologic Studies Depression Scale (CESD-10). For each PD patient at each time point, we calculated the difference between CESD-10 score and its expected value estimated based on data from individuals without PD, and then realigned the time scale in reference to the year of PD diagnosis. We examined longitudinal changes in CESD-10 scores before and after PD diagnosis using a joint modeling approach to account for competing risks of non-participation and death. Results A total of 79 PD patients were identified at enrollment or during the follow-up, with repeatedly assessed depressive symptom data up to 9 years before and after PD diagnosis. We found a monotonic trend of increasing CESD-10 score in PD patients throughout the observational period (p = 0.002). The observed scores became higher than expected approximately 7 years before PD diagnosis and significantly different 1 year before PD diagnosis. Conclusions Increasing depressive symptomatology appears to precede PD diagnosis by a few years.

Efficacy of non-pharmacological interventions on depressive symptoms in patients with Parkinson’s disease: a study protocol for a systematic review and network meta-analysis

“… 19 However, the pathophysiological mechanism of PD depression is not yet fully clear; it may be related to brain structure changes, including those in the limbic system and amygdala, as well as pathological changes such as monoaminergic disturbances, hippocampal atrophy and neuroinflammation. 20 21 …”

“…Imaging studies found that PD-associated depression is linked with numerous anatomical changes occurring in the amygdala, thalamus, hippocampus and ventral striatum 19. However, the pathophysiological mechanism of PD depression is not yet fully clear; it may be related to brain structure changes, including those in the limbic system and amygdala, as well as pathological changes such as monoaminergic disturbances, hippocampal atrophy and neuroinflammation 20 21…”

Chronic diseases and multimorbidity patterns, their recent onset, and risk of new-onset Parkinson's disease and related functional degeneration in older adults: a prospective cohort study

“…Previous research has indicated positive associations between certain chronic conditions, such as cardiometabolic diseases, arthritis, and depressive symptoms, and new-onset PD. 7 , 8 , 9 , 10 However, evidence on other chronic diseases, such as digestive diseases, lung diseases, and cataracts, has not been examined in detail. Given that approximately one-third of adults worldwide exhibit two or more chronic diseases, 5 further investigation of the association between multimorbidity and the onset of PD and its related functional degeneration is of substantial practical importance.…”