Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing, MI, United States of America.
Department of Neurology, Hersey Medical Center, Pennsylvania State University, Hersey, PA, United States of America.
PLoS One. 2022 Jul 29;17(7):e0272315. doi: 10.1371/journal.pone.0272315. eCollection 2022.
Depression is common in Parkinson's disease (PD). It is however unclear when and how depressive symptoms develop and progress in the course of PD development.
To assess how depressive symptoms evolve in PD, using repeated measures.
In 2994 older adults, ages 70-79 years, depressive symptoms were assessed 8 times over 11 years using the 10-item Center for Epidemiologic Studies Depression Scale (CESD-10). For each PD patient at each time point, we calculated the difference between CESD-10 score and its expected value estimated based on data from individuals without PD, and then realigned the time scale in reference to the year of PD diagnosis. We examined longitudinal changes in CESD-10 scores before and after PD diagnosis using a joint modeling approach to account for competing risks of non-participation and death.
A total of 79 PD patients were identified at enrollment or during the follow-up, with repeatedly assessed depressive symptom data up to 9 years before and after PD diagnosis. We found a monotonic trend of increasing CESD-10 score in PD patients throughout the observational period (p = 0.002). The observed scores became higher than expected approximately 7 years before PD diagnosis and significantly different 1 year before PD diagnosis.
Increasing depressive symptomatology appears to precede PD diagnosis by a few years.
抑郁症在帕金森病（PD）中很常见。然而，尚不清楚抑郁症状在 PD 发展过程中何时以及如何发展和进展。
使用重复测量评估 PD 患者中抑郁症状的演变。
在 2994 名年龄在 70-79 岁的老年人中，在 11 年内使用 10 项流行病学研究中心抑郁量表（CESD-10）评估了 8 次抑郁症状。对于每个 PD 患者在每个时间点，我们计算了 CESD-10 评分与其基于无 PD 个体数据估计的预期值之间的差异，然后根据 PD 诊断年份重新调整时间尺度。我们使用联合建模方法来评估 PD 诊断前后 CESD-10 评分的纵向变化，以考虑非参与和死亡的竞争风险。
在入组或随访期间共发现 79 例 PD 患者，他们的抑郁症状数据在 PD 诊断前和后进行了长达 9 年的重复评估。我们发现 PD 患者在整个观察期间 CESD-10 评分呈单调上升趋势（p = 0.002）。在 PD 诊断前大约 7 年前观察到的评分开始高于预期，并且在 PD 诊断前 1 年前明显不同。
抑郁症状的增加似乎在 PD 诊断前几年就已经出现。
