Abstract Details

Title Screening for Depression and Dementia in Parkinson's Disease Provides Information on Mortality Risk

Topic Movement Disorders

Presentation(s) P06 - (-)

Poster/Presentation
Number 095

Objective

Background BACKGROUND: PD is the 14th leading cause of the death in the United States and accounts for over 10% of all deaths from neurologic/psychiatric conditions in developed nations. Prior work shows the presence of both dementia and depression contribute to PD mortality risk. However, the extent to which depressive symptoms contribute to mortality beyond the risk attributable to dementia presents a gap in our clinical knowledge.

Design/Methods DESIGN/METHODS: After obtaining informed consent, 155 PD patients were screened for both depression and dementia, interviewed to obtain a psychiatric and medical history, and underwent neurological examination. We investigated relationships between positive baseline screening for depression (Beck Depression Inventory cutoff 13/14 ), possible dementia (Mini-Mental State Examination cutoff 24/25 ), and all-cause mortality over a 28 year follow-up period using a multivariate Cox proportional hazards model.

Results RESULTS: Depression (HR = 1.58, p = 0.037; 95% CI 1.03-2.44) was predictive of shorter survival, independent of age at PD onset (HR = 1.07, p < 0.001; 95% CI 1.04-1.10); disease duration at examination (HR = 1.06, p = 0.012; 95% CI 1.01-1.11); possible dementia (HR = 1.72, p < 0.001; 95% CI 1.17-2.53); and sex, years of education, Hoehn and Yahr stage, psychiatric history, and use of antidepressants, anxiolytics, levodopa, or bromocriptine (all p's > 0.05).

Conclusions CONCLUSIONS: These data confirm a clear additive effect of threshold level depressive symptomatology, beyond dementia and clinicodemographic factors, on mortality risk in PD. Ultimately, depression screens such as the Beck Depression Inventory may serve as simple (obtainable in less than five minutes during a clinic visit), low-cost prognostic indicators for mental health and mortality in PD.

Authors/Disclosures
Blake K. Scanlon, PhD (Stanford/VA CADC) PRESENTER	No disclosure on file
Heather Katzen, PhD	Dr. Katzen has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Adult Hydrocephalus Clinical Research Network. Dr. Katzen has received publishing royalties from a publication relating to health care.
Bonnie E. Levin, PhD	No disclosure on file
Thomas A. Berger, MD (Dept. of Neurology, Medical University of Vienna)	Prof. Berger has received personal compensation in the range of $10,000-$49,999 for serving as a speaker at scientific meetings and participant of local and international advisory boards with various companies producing and markerting treatments for multiple sclerosis (Almirall, Biogen, Biologix, Bionorica, Celgene-BMS, Merck, Novartis, Roche, Sanofi-Genzyme, TG Therapeutics, UCB).

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