Introduction: Depression is a common non-motor symptom in Parkinson's disease (PD) with a significant impact on quality of life and overall prognosis. Despite the availability of effective treatments, many PD patients with depression do not receive timely diagnosis and appropriate intervention. This study aimed to identify risk factors for depression progression in PD to inform clinical practice and future research.
Methods: We conducted a retrospective cohort study of PD patients using registry data from the Parkinson's Progression Markers Initiative (PPMI) dataset. The primary outcome was depression progression, defined as a 2-point or greater increase in the MDS-UPRDS depression score within the first two years of study enrollment.
Results: A total of 485 PD patients were included in the study, of which 78 (16.1%) experienced depression progression. Significant predictors of depression progression included older age at diagnosis (p=0.088), higher MDS-UPRDS Part 2 scores (motor function in activities of daily living, p=0.053), and race, with Black and Asian individuals demonstrating an over 7-fold and 4-fold increased risk, respectively, compared to White individuals (p=0.001).
Discussion: Our findings highlight the importance of depression as a risk factor for progression in PD, emphasizing the need for proactive screening and interventions targeting mental health in PD management. The identification of age, motor impairment, and race as predictors of depression progression underscores the importance of tailored approaches that address the unique needs of diverse patient populations. Further research and collaborative efforts are warranted to elucidate the underlying mechanisms, evaluate the impact of racial disparities, and develop strategies to improve outcomes and quality of life for individuals living with PD.
Conclusion: This study provides valuable insights into the risk factors for depression progression in PD, with important implications for clinical practice and future research. Additionally, our findings highlight the need for proactive screening and interventions targeting mental health in PD management, tailored to the unique needs of diverse patient populations.