Latent growth-curve analysis reveals that worsening Parkinson's disease quality of life is driven by depression.

Parkinson's disease (PD) is a neurodegenerative disorder resulting in a wide variety of symptoms. The current study examined the influence of apathy, depression and motor symptoms on quality of life (QoL) in PD patients. Information was drawn from an 18-month period. Participants (N = 397) were assessed for apathy (Apathy Scale; Starkstein et al., 1992), depression (Beck Depression Inventory-II; Beck, Steer, Ball & Ranieri, 1996), motor severity (Unified Parkinson's Disease Rating Scale, Part III; UPDRS; Fahn, Elton & Committee, 1987), and QoL (Parkinson's Disease Questionnaire-39; Jenkinson, Fitzpatrick, Peto, Greenhall, & Hyman,1997) at 3 time points: an initial clinical evaluation (baseline), a 6-month follow-up, and an 18-month follow-up. Latent growth-curve models were used to determine the influence of apathy, depression, and motor symptoms on QoL trajectories. Greater difficulties with QoL at baseline showed the strongest relationship to more severe depression symptoms, followed by more severe motor symptoms, younger age, and less education (all p values < .001). Worsening of QoL over the 18-month period was only predicted by a worsening of depression (p = .003). The relationship between QoL and depression symptoms remained significant in a subsample of nondepressed PD patients. Overall, findings from the current study suggest that self-reported QoL among PD patients is primarily related to depression. Future efforts to improving clinical care of PD patients may benefit by focusing on improving psychosocial adjustment or treatments targeting depression.

Jones JD ，Marsiske M ，Okun MS ，Bowers D ... -  《-》

Mood and motor trajectories in Parkinson's disease: multivariate latent growth curve modeling.

Zahodne LB ，Marsiske M ，Okun MS ，Rodriguez RL ，Malaty I ，Bowers D ... -  《-》

Apathy in elderly nondemented patients with Parkinson's disease: clinical determinants and relationship to quality of life.

Skorvanek M ，Rosenberger J ，Gdovinova Z ，Nagyova I ，Saeedian RG ，Groothoff JW ，Dijk JP ... -  《JOURNAL OF GERIATRIC PSYCHIATRY AND NEUROLOGY》

Baseline predictors of worsening apathy in Parkinson's disease: A prospective longitudinal study.

Apathy is one of the most common behavioural disorders in Parkinson's disease (PD) and contributes significantly to a reduced quality of life in PD patients. We conducted a prospective longitudinal study of 89 mild PD patients over 18 months, measuring apathy symptoms at 6-monthly intervals using the Starkstein Apathy Scale, as well as measures of motor and non-motor symptoms, cognitive function, and functional disability at baseline. Mixed-effects models were used to characterise the individual trajectories of apathy symptom severity, and linear regression with stepwise elimination procedure was used to select significant baseline predictors. Clinically significant levels of apathy were present in 42.7% of our sample at baseline, with symptom severity remaining relatively stable on average over the course of 18 months. Male gender, lower educational attainment, higher depression symptom severity, more severe functional disability, and the presence of dyskinesias at study entry predicted increasing apathy over the subsequent 18 months. Patients with these factors are at risk for progression of apathy, which may be prevented by treating depression and functional disability. Further studies are needed to address both the specific neurobiological pathways and psychosocial factors underpinning apathy in PD.

Wee N ，Kandiah N ，Acharyya S ，Chander RJ ，Ng A ，Au WL ，Tan LC ... -  《-》

Anxiety and Depression Are Better Correlates of Parkinson's Disease Quality of Life Than Apathy.

Jones JD ，Butterfield LC ，Song W ，Lafo J ，Mangal P ，Okun MS ，Bowers D ... -  《-》