Department of Neurology, Jena University Hospital, Am Klinikum 1, 07747, Jena, Germany.
Center for Healthy Ageing, Jena University Hospital, Jena, Germany.
Health Qual Life Outcomes. 2021 Mar 25;19(1):107. doi: 10.1186/s12955-021-01753-5.
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.
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.
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.
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.
在帕金森病（PD）患者中，抑郁对生活质量（QoL）有很大的影响。然而，对于亚临床抑郁（STD）对 PD 患者 QoL 的影响知之甚少。
本观察性研究共纳入 230 名认知功能正常和受损的住院 PD 患者。我们收集了以下数据进行分析：贝克抑郁量表（BDI）水平、蒙特利尔认知评估（MoCA）评分、非运动症状问卷评分、帕金森病问卷 39 项（PDQ-39）评分、Hoehn-Yahr 分期和运动障碍协会修订的统一帕金森病评定量表第三部分（MDS-UPDRS III）评分。为了研究 STD 对 PDQ-39 综合指数（SI）及其各领域的影响，我们使用了多变量方差分析和多变量协方差分析。
在本队列中，80 名（34.8%）患者有 STD[44 名（32.3%）MoCA 评分较高（>21）和 36 名（38.3%）MoCA 评分较低（<21）]。在 PDQ-39 SI 中，抑郁水平有显著影响。在 MoCA 评分较高的患者中，STD 与 PDQ-39 中情绪健康和认知领域较差相关，而在 MoCA 评分较低的患者中，STD 对 PDQ-39 SI 或其各亚领域无显著影响。
在 PD 患者中，QoL 明显受到 STD 的影响，因此，医疗护理应更加关注 STD 的治疗。然而，这种影响仅在认知功能正常的 PD 患者中观察到。STD 患者的 QoL 比非抑郁患者明显降低，这表明 STD 应被视为正常情绪和抑郁之间的过渡区。
