Introduction
Methods
Study design and participants
Assessment of baseline variables
Ascertainment of depression
Statistical analysis
Results
Variables associated with depression at baseline (cross-sectional analysis)
Total | With depression | Without depression |
p
| |
---|---|---|---|---|
N
| 411 | 87 | 324 | |
Age (year) | 61.07 (11.38) | 63.65 (12.49) | 60.38 (10.97) | 0.02f
|
Sex (% female) | 35.5 | 42.5 | 33.6 | 0.12a
|
Antidepressants (%) | 15.4 | 19.5 | 14.2 | 0.22 |
Education (year) | 11.97 (4.11) | 11.47 (4.49) | 12.10 (4.00) | 0.20 |
Disease duration (year) | 10.64 (6.55) | 12.00 (6.67) | 10.28 (6.47) | 0.03f
|
Age at onset (year) | 50.43 (11.87) | 51.66 (11.98) | 50.11 (11.84) | 0.28 |
Hoehn and Yahr, stage | 2 (2, 3) | 3 (2, 4) | 2 (2, 3) | <0.001b,f
|
SPES/SCOPA motor impairments | 13.31 (4.90) | 15.48 (5.30) | 12.71 (4.59) | <0.001f
|
SPES/SCOPA Dyskinesias | 0.94 (1.62) | 1.41 (1.82) | 0.81 (1.54) | 0.006f
|
SPES/SCOPA motor fluctuations | 0.78 (1.26) | 1.19 (1.57) | 0.67 (1.14) | 0.006f
|
SPES/SCOPA ADL | 8.92 (3.56) | 10.86 (3.93) | 8.40 (3.28) | <0.001f
|
Motor phenotype, PIGD dominant (%) | 45.1 | 71.1 | 38.2 | <0.001a,f
|
Beck depression inventory | 10.21 (6.57) | 20.06 (5.86) | 7.57 (3.54) | <0.001f
|
SCOPA-COGc
| 25.32 (6.67) | 22.13 (7.54) | 26.18 (6.15) | <0.001f
|
SCOPA-SLEEP, NSd
| 4.52 (3.77) | 7.12 (3.87) | 3.83 (3.44) | <0.001f
|
SCOPA-SLEEP, EDSd
| 4.88 (3.74) | 6.14 (3.83) | 4.54 (3.64) | <0.001f
|
SCOPA-AUT, GI scoree
| 2.72 (2.20) | 3.79 (2.31) | 2.43 (2.08) | <0.001f
|
SCOPA-AUT, UR scoree
| 6.72 (4.03) | 8.46 (4.46) | 6.28 (3.79) | <0.001f
|
SCOPA-AUT, CV scoree
| 1.16 (1.19) | 1.83 (1.37) | 0.98 (1.08) | <0.001f
|
Hallucinations, % with | 17.0 | 30.0 | 13.7 | 0.001a,f
|
Total LDE (mg/day) | 609 (464) | 670 (423) | 593 (474) | 0.17 |
LDE-Dopa (mg/day) | 380 (375) | 441 (363) | 363 (378) | 0.09 |
LDE-DA dose (mg/day) | 232 (226) | 229 (218) | 232 (229) | 0.90 |
Variables associated with longitudinal changes in BDI (LMM analysis)
Variable | Unadjusted modela
| Adjusted modelb
| Final modelc
| |||
---|---|---|---|---|---|---|
B (95 % CI) |
p
|
B (95 % CI) |
p
|
B (95 % CI) |
p
| |
Age | 0.10 (0.07–0.12) | <0.001g
| −0.01 (−0.03 to 0.03) | 0.85 | ||
Female gender | 1.62 (1.04–2.21) | <0.001g
| 1.08 (0.49 to 1.67) | <0.001g
| 0.96 (0.44–1.48) | <0.001g
|
SPES/SCOPA—motor impairment | 0.33 (0.26–0.39) | <0.001g
| 0.05 (−0.03 to 0.12) | 0.25 | ||
SPES/SCOPA—ADL | 0.63 (0.55–0.70) | <0.001g
| 0.14 (0.01–0.26) | 0.04g
| 0.16 (0.07–0.25) | <0.001g
|
SPES/SCOPA—Dyskinesia | 0.67 (0.50–0.85) | <0.001g
| −0.12 (−0.33 to 0.09) | 0.25 | ||
SPES/SCOPA—motor fluctuations | 1.20 (0.97–1.42) | <0.001g
| 0.30 (0.06–0.54) | 0.02g
| 0.35 (0.14–0.56) | 0.001g
|
PIGD dominant phenotype | 2.71 (2.14–3.28) | <0.001g
| 0.13 (−0.48 to 0.74) | 0.68 | ||
SCOPA-COG scored
| −0.30 (−0.34 to 0.26) | <0.001g
| −0.20 (−0.25 to 0.15) | <0.001g
| −0.19 (−0.23 to 0.14) | <0.001g
|
Presence of hallucinations | 3.60 (2.83–4.36) | <0.001g
| 0.25 (−0.55 to 1.05) | 0.54 | ||
SCOPA-SLEEP-NS scoree
| 0.53 (0.46–0.60) | <0.001g
| 0.43 (0.35–0.50) | <0.001g
| 0.47 (0.40–0.54) | <0.001g
|
SCOPA-SLEEP-DS scoree
| 0.51 (0.37–0.66) | <0.001g
| 0.23 (0.15–0.31) | <0.001g
| 0.25 (0.18–0.32) | <0.001g
|
SCOPA-AUTf GI score | 0.85 (0.73–0.98) | <0.001g
| 0.28 (0.14–0.43) | <0.001g
| 0.10 (−0.03 to 0.23) | 0.13 |
SCOPA-AUTf CV score | 1.61 (1.37–1.84) | <0.001g
| 0.45 (0.19–0.72) | 0.001g
| 0.36 (0.13–0.60) | 0.002g
|
SCOPA-AUTf UR score | 0.57 (0.50–0.64) | <0.001g
| 0.13 (0.04–0.21) | 0.003g
| 0.18 (0.11–0.25) | <0.001g
|
Daily levodopa dose, p/100 mg | 0.40 (0.32–0.48) | <0.001g
| −0.04 (−0.13 to 0.06) | 0.44 | ||
Daily DA dose, p/100 mg | 0.12 (−0.14 to 0.37) | 0.37 | ||||
Use of antidepressants | 2.82 (2.01–3.62) | <0.001g
| 1.52 (0.75–2.30) | <0.001g
| 1.55 (0.86–2.24) | <0.001g
|
Variables associated with persistent depression
Risk factors for future development of depression (survival analysis)
Unadjusted modela
| Adjusted modelb
| Final modelc
| ||||
---|---|---|---|---|---|---|
HR (95 % CI) |
p
| HR (95 % CI) |
p
| HR(95 % CI) |
p
| |
Age, p/year increase | 1.03 (1.01–1.05) | 0.007g
| 1.01 (0.98–1.04) | 0.45 | ||
Gender, HR for females | 1.09 (0.71–1.67) | 0.70 | ||||
Baseline BDI score, p/point increase | 1.31 (1.23–1.40) | <0.001g
| 1.29 (1.19–1.40) | <0.001g
| 1.27 (1.18–1.36) | <0.001g
|
Disease duration, p/year increase | 1.01 (0.98–1.05) | 0.38 | ||||
SPES/SCOPA—motor impairments | 1.04 (0.98–1.09) | 0.18 | ||||
SPES/SCOPA—ADL | 1.11 (1.04–1.18) | 0.001g
| 0.98 (0.91–1.06) | 0.64 | ||
SPES/SCOPA—Dyskinesia | 1.12 (0.99–1.27) | 0.07 | ||||
SPES/SCOPA—motor fluctuations | 1.24 (1.06–1.46) | 0.008g
| 0.92 (0.75–1.13) | 0.42 | ||
Motor phenotype, HR for PIGD dominant | 1.56 (1.02–2.38) | 0.04g
| 0.90 (0.54–1.50) | 0.69 | ||
SCOPA-COGd, p/point increase | 0.95 (0.92–0.98) | 0.002g
| 0.97 (0.93–1.01) | 0.18 | ||
Presence of hallucinations, yes/no | 2.11 (1.23-3.64) | 0.007g
| 1.42 (0.78–2.59) | 0.26 | ||
SCOPA-SLEEP-DSe, p/point increase | 1.16 (1.10–1.22) | <0.001g
| 1.11 (1.05–1.18) | 0.001g
| 1.10 (1.04–1.17) | 0.001g
|
SCOPA-SLEEP-NSe, p/point increase | 1.09 (1.03–1.15) | 0.002g
| 0.99 (0.92–1.06) | 0.68 | ||
SCOPA-AUT, GIf score p/point increase | 1.01 (1.00–1.21) | 0.05g
| 0.92 (0.82–1.03) | 0.16 | ||
SCOPA-AUT, CVf score p/point increase | 1.33 (1.13–1.34) | 0.001g
| 1.10 (0.89–1.35) | 0.38 | ||
SCOPA-AUT, URf score p/point increase | 1.09 (1.03–1.14) | 0.002g
| 0.98 (0.91–1.05) | 0.60 | ||
Daily levodopa dose, p/100 mg increase | 1.12 (1.07–1.18) | <0.001g
| 1.12 (1.03–1.21) | 0.006g
| 1.09 (1.03–1.15) | 0.004g
|
Daily DA dose, p/100 mg increase | 1.12 (1.03–1.21) | 0.007g
| 1.08 (0.97–1.20) | 0.15 | ||
Use of antidepressants, yes/no | 1.51 (0.87–2.63) | 0.15 |