Clinical Study On The Depression And Cognitive Impairment In Parkinson's Disease

Objective:To investigate the depression and cognitive impairment in patients with Parkinson's disease(PD).Methods:Depression and cognitive function in 41 patients with PD and 20 normal controls were evaluated by HAMD,SDS,MMSE,CDR,CDT.Motor function for PD patients was evaluated by Unified Parkinson's Disease Rating Scale(UPDRS). PD patients were divided into depression(PDD group) and non-depression(PDND group) according to HAMD scores .The relation of examination results was analyzed between PDD group and PDND group. PD patients were divided into cognitive impairment and non-cognitve impairment according to CDR, and risk factors for cognitive impairment were studied by logistic regression analysis.Results:(1)Depression in PD(HAMD(7.9±4.2), SDS(48.6±10.9))were significantly higher than that in normal controls(HAMD(3.4±2.9), SDS (38.6±6.9)) (P<0.01).Among 41 PD patients there were 18 (43.9%) cases whose HAMD scoes≥8 and 17 (41.5%) cases SDS scoes≥53, while only one case(5%) in the control guoups whose HAMD scoes≥8 and SDS scoes≥53 (P<0.01).(2)Cognitive function in PD(CDT(3.1±1.0), MMSE(25.4±3.4))were obviously degraded than that in normal controls(CDT(3.8±0.6)(P<0.01), MMSE(26.9±2.0) (P<0.05)).The incidence of cognitive impairment in PD (53.7%) was higer than that in the contol group(5.0%) according to CDR(P<0.01).(3)Depression in PD is obviously related to severity of dysfunction and duration of disease . UPDRS scores were significantly higher in the PDD group(50.7±22.7) than that in the PDND group(28.5±13.6) (P<0.01).And the duration of disease were longer in the PDD group(6.3±6.1 years) than that in the PDND group(2.5±3.0 years) (P<0.05). While the age, gender, education, age of onset were similar between the two groups.(4) The incidence of cognitive impairment in PDD group was higer than that in the PDND group. Among 18 patients of PDD group 15 (83.3%) cases were suspected as cognitive impairment according to CDR , while 7 cases(30.3%) of the PDND group were suspected as cognitive impairment(P < 0.01). Depression(OR=1.44, 95%CI=1.041-1.994) and severity of dysfunction (OR=1.13, 95%CI=1.030-1.247) are risk factors of cognitive impairment in PD . Conclusion:(1) Depression exists in patients with Parkinson's disease(PD).The severity of depression in PD is mainly mild to moderate.Depression in PD is obviously related to severity of dysfunction and duration of disease .(2) Cognitive impairment exists in patients with PD. The severity of cognitive impairment in PD is mainly mild to moderate.(3) The incidence of cognitive impairment in PD with depression was higer than that in PD with non-depression . Depression and severity of dysfunction are risk factors of cognitive impairment in PD.