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Observational Study
. 2021 Mar 25;19(1):107.
doi: 10.1186/s12955-021-01753-5.

Impact of subthreshold depression on health-related quality of life in patients with Parkinson's disease based on cognitive status

Aline Schönenberg  1 , Hannah M Zipprich  1   2 , Ulrike Teschner  1 , Julian Grosskreutz  1   2 , Otto W Witte  1   2 , Tino Prell  3   4
Affiliations
Observational Study

Impact of subthreshold depression on health-related quality of life in patients with Parkinson's disease based on cognitive status

Aline Schönenberg et al. Health Qual Life Outcomes. .

Abstract

Background: In patients with Parkinson's disease (PD), depression has a strong impact on quality of life (QoL). However, little is known about the influence of subthreshold depression (STD) on QoL in PD patients.

Methods: A total of 230 hospitalized PD patients with normal and impaired cognitive status were included in this observational study. We collected the following data for analysis: Beck Depression Inventory level, Montreal Cognitive Assessment (MOCA) score, non-motor symptoms questionnaire score, PD questionnaire-39 (PDQ-39) score, Hoehn-Yahr stage, and Movement Disorder Society-sponsored revision of the unified PD rating scale III (MDS-UPDRS III) score. To study the impact of STD on the PDQ-39 summary index (SI) and its domains, we used multivariate analysis of variance and multivariate analysis of covariance.

Results: In this cohort, 80 (34.8%) patients had STD [44 (32.3%) with high MOCA score (> 21) and 36 (38.3%) with low MOCA score (< 21)]. In PDQ-39 SI, there was a significant effect on depression level. In patients with higher MOCA score, STD was associated with worse PDQ-39 domains emotional well-being and cognition, whereas in patients with lower MOCA score, STD had no significant effect on PDQ-39 SI or its subdomains.

Conclusion: In PD patients, QoL is significantly affected by STD, and thus, more attention in medical care should be focused on treating STD. However, the impact is only observable in PD patients with normal cognitive function. STD patients show more reduced QoL than non-depressed patients, indicating that STD should be treated as a transition zone between normal mood and depression.

Keywords: Cognitive impairment; Dementia; Non-motor symptoms; Parkinson’s disease; Quality of life; Subthreshold depression.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Polar plot for the different PDQ-39 domains for patients without depression, with subthreshold depression and with depression (in the subgroup of patients with normal MOCA)
Fig. 2
Fig. 2
Polar plot for the different PDQ-39 domains depending on MOCA scores
Fig. 3
Fig. 3
Responses to the BDI II items in PD patients with higher and lower MOCA scores
See this image and copyright information in PMC

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