Vascular risk factors and depression in Parkinson's disease

The aim of this study was to address the vascular depression hypothesis in Parkinson's disease (PD) from a large cohort of Chinese population.

A cross-sectional analysis of 1784 Chinese patients with PD was conducted. Patients were divided into absence of depression (score ≤ 20) and presence of depression (score > 20) based on assessment of the Hamilton Depression Rating Scale. Other clinical assessments included the Unified PD Rating Scale (UPDRS), the Hamilton Anxiety Rating Scale, the frontal assessment battery (FAB) and the Montreal Cognitive Assessment (MoCA).

Patients with depression showed a higher proportion of women, longer disease duration, higher UPDRS part III score, higher levodopa equivalent daily dose use, higher occurrences of motor fluctuation and dyskinesia, lower FAB score and lower MoCA score than those without depression (P < 0.05). The proportions of drinking and overweight/obesity in the depression group were significantly lower than those in the non-depression group (P < 0.05). A forward binary logistic regression model indicated that depression in PD was associated with female sex [odds ratio (OR) 1.376, P = 0.025], higher UPDRS part III score (OR 1.042, P < 0.001), lower FAB score (OR 0.937, P = 0.015), anxiety (OR 18.156, P < 0.001) and overweight/obesity (OR 0.700, P = 0.019), whereas no associations were found with hypertension, diabetes, smoking, drinking, hyperlipidaemia and heart disease.

Our study failed to verify the vascular depression hypothesis in PD. On the contrary, it was demonstrated that overweight/obesity is negatively associated with the presence of depression in PD.