Synergistic associations of depressive symptoms and aging on cognitive decline in early Parkinson’s disease

IF 1.9 Q3 CLINICAL NEUROLOGY
Lea Hemphill , Yenny Valenzuela , Kenya Luna , Sarah M. Szymkowicz , Jacob D. Jones
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引用次数: 2

Abstract

Objective

Parkinson's disease (PD) is the second most common progressive neurodegenerative disorder. About 40%–50% of PD patients experience depression, making it one of the most common neuropsychiatric disturbances in PD. Cognitive deficits (e.g., difficulties with memory, attention) are an additional common complication in PD. Past studies among healthy aging individuals suggest that depression is a risk factor for cognitive decline, and the risk increases with older age. This study aims to examine the association between depressive symptoms on cognitive decline as a function of age among patients with PD. It is hypothesized that older PD patients with more severe depressive symptoms will be at greater risk of cognitive decline than their younger or less depressed counterparts.

Methods

Four hundred and eighty-seven newly diagnosed patients with PD, were assessed for depression and cognition over a five-year period. Participants completed neuropsychological tests that assessed memory, learning, attention, visuospatial functioning, processing speed, and verbal fluency. Multilevel-modeling was used to examine the longitudinal association between cognition, age, and depressive symptoms.

Results

Our results indicated a significant three-way interaction (age X occasion X depressive symptoms) predicting language and working memory/attention performance. More specifically, detrimental associations of depressive symptoms on cognitive decline in these domains were more pronounced among older adults.

Conclusions

Our findings support that older PD patients with comorbid depressive symptoms experience greater cognitive decline compared to their younger counterparts. Findings suggest that older individuals with PD may be more vulnerable to neurotoxic effects of depression (e.g., neuroinflammation, HPA axis disruption), and better management of depression could potentially reduce cognitive decline and dementia risk.

Abstract Image

Abstract Image

抑郁症状和衰老在早期帕金森病认知能力下降中的协同关联
帕金森病(PD)是第二常见的进行性神经退行性疾病。大约40%-50%的帕金森病患者患有抑郁症,这使其成为帕金森病中最常见的神经精神障碍之一。认知缺陷(如记忆和注意力困难)是帕金森病的另一个常见并发症。过去对健康老年人的研究表明,抑郁症是认知能力下降的风险因素,并且随着年龄的增长,风险会增加。本研究旨在检验抑郁症患者的抑郁症状与认知能力下降之间的关系,这是PD患者年龄的函数。假设患有更严重抑郁症状的老年PD患者比年轻或抑郁程度较低的患者有更大的认知能力下降风险。方法对487例新诊断的帕金森病患者进行为期5年的抑郁和认知评估。参与者完成了神经心理学测试,评估了记忆、学习、注意力、视觉空间功能、处理速度和语言流利性。使用多层次模型来检验认知、年龄和抑郁症状之间的纵向关联。结果我们的研究结果表明,语言和工作记忆/注意力表现存在显著的三元交互作用(年龄X场合X抑郁症状)。更具体地说,抑郁症状与这些领域认知能力下降的有害关联在老年人中更为明显。结论我们的研究结果支持,与年轻人相比,患有合并抑郁症状的老年帕金森病患者的认知能力下降幅度更大。研究结果表明,患有帕金森病的老年人可能更容易受到抑郁症的神经毒性影响(如神经炎症、HPA轴破坏),更好地管理抑郁症可能会降低认知能力下降和痴呆风险。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Clinical Parkinsonism  Related Disorders
Clinical Parkinsonism Related Disorders Medicine-Neurology (clinical)
CiteScore
2.70
自引率
0.00%
发文量
50
审稿时长
98 days
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