[Depression and dementia: the most frequent non-motor symptoms of Parkinson disease]

Abstract

The aim of our study was to assess the frequency, risk factors, and interrelations between depression and dementia in P.D.

Material and methods: 100 consecutive patients with P.D. with good response to L-dopa and normal CT/MRI scans, mean age: 66 (41-81) years, mean disease duration 6.7 (0-24) years. Rating scales: for stage of disease and motor disability: Hoehn-Yahr (HY), Schwab-England (SE), Unified Parkinson's Disease Rating Scale (UPDRS), for depression: Montgomery-Asberg Depression Rating Scale (MADRS), for dementia: Mini Mental State Examination (MMSE), for quality of life: Parkinson's Disease Questionnaire (PDQ-39) and own questionnaire (demographic data and treatment).

Results: Depression (MADRS > 19) was revealed in 35% and dementia (MMSE < or = 23) in 19% of patients. Depressed and demented patients had significantly more advanced motor disability (UPDRS, HY, SE) and poor quality of life (PDQ-39). In group with dementia disease duration was longer (9.4 vs 6.0 years; p < 0.009), mean age was higher (71.3 vs 64.7 years; p < 0.002) and sleep disturbances, depression and hallucinations more frequent (p < 0.04). Groups with and without depression did not differ significantly in terms of dementia (MMSE).

Conclusions: Depression and dementia are more frequent in patients with greater motor disability and correlated significantly with poor quality of life. Old age, longer disease duration, hallucinations and sleep disturbances are risk factors for dementia in P.D. In demented patients with P.D. depression is more frequent.