Department of Health Statistics, School of Public Health, Shanxi Medical University, Taiyuan, China.
Shanxi Provincial Key Laboratory of Major Diseases Risk Assessment, China.
Clin Gerontol. 2024 May-Jun;47(3):426-435. doi: 10.1080/07317115.2022.2111014. Epub 2022 Aug 11.
Whether depression affects activities of daily living (ADLs) in patients with Parkinson's disease (PD) via excessive daytime sleepiness (EDS) remains unclear; moreover, few longitudinal studies have been conducted.
We recruited 421 patients from the Parkinson's Progression Markers Initiative. We constructed a latent growth mediation model to explore the longitudinal mediating effect of depression on the relationship between EDS and ADLs.
EDS ( < .001) and depression scores ( < .001) both increased, and ADL scores ( < .001) decreased. Moreover, EDS was positively correlated with depression, whereas an increase in EDS significantly reduced ADLs. The initial value (95% confidence interval [CI]: 0.026, 0.154) and the rate of change (95% CI: 0.138, 0.514) of self-reported depression measured using the Geriatric Depression Scale(GDS) partially mediated the association between EDS and ADL score.
The indirect effect of the longitudinal changes of depression on the relationship between EDS and ADLs highlights the importance of depression changes in PD patients with EDS.
Depression should be considered a mediator by clinicians; preventing the worsening of depression is essential for improving ADLs in patients with PD, especially those with EDS.
目前尚不清楚抑郁是否通过日间过度嗜睡（EDS）影响帕金森病（PD）患者的日常生活活动（ADL）；此外，很少有纵向研究对此进行过探讨。
我们从帕金森病进展标志物倡议中招募了 421 名患者。我们构建了一个潜在的增长中介模型，以探讨抑郁对 EDS 与 ADL 之间关系的纵向中介作用。
EDS（<0.001）和抑郁评分（<0.001）均升高，ADL 评分（<0.001）降低。此外，EDS 与抑郁呈正相关，而 EDS 的增加显著降低了 ADL。使用老年抑郁量表（GDS）测量的初始值（95%置信区间[CI]：0.026，0.154）和变化率（95%CI：0.138，0.514）部分中介了 EDS 与 ADL 评分之间的关系。
抑郁对 EDS 和 ADL 之间关系的纵向变化的间接影响突出了 EDS 帕金森病患者中抑郁变化的重要性。
临床医生应将抑郁视为一种中介因素；预防抑郁恶化对于改善 PD 患者，尤其是伴有 EDS 的患者的 ADL 至关重要。
