[Dementia and depression determine care dependency in Parkinson's disease: analysis of 1,449 outpatients receiving nursing care in Germany]

Riedel, O., Dodel, R., Deuschl, G., Forstl, H., Henn, F., Heuser, I., Oertel, W., Reichmann, H., Riederer, P., Trenkwalder, C., Wittchen, H. U. (August 2011) [Dementia and depression determine care dependency in Parkinson's disease: analysis of 1,449 outpatients receiving nursing care in Germany]. Nervenarzt, 82 (8). pp. 1012-9. ISSN 0028-2804

URL: http://www.ncbi.nlm.nih.gov/pubmed/21523443
DOI: 10.1007/s00115-010-3186-2

Abstract

BACKGROUND: Parkinson's disease (PD) is frequently accompanied by dementia or depression which can aggravate the clinical picture of the disease and increase the risk of care dependency (CD). Little is known about the associations between PD, these neuropsychiatric comorbidities and CD in outpatients. PATIENTS AND METHODS: A nationwide sample of outpatients (n=1,449) was examined by office-based neurologists (n=315) comprising the documentation of the general, neurological status and the degree of CD. The dementia status was clinically rated according to the established DSM-IV criteria. Depression was screened with the Montgomery-Asberg Depression Rating Scale (MADRS). RESULTS: Overall, 18.3% of all patients were care dependent. Even after adjustment for PD severity, patients with depression (OR=2.8; 95% CI 1.8-4.3), dementia (OR=2.7; 95% CI 1.8-4.1) or both (OR=3.9; 95% CI 2.5-60,0) were at higher risk for CD than patients without dementia or depression. Patients aged >/=76 years were fourfold more likely to be care dependent than patients aged </=65 years (OR=3.5; 95% CI 2.3-5.5). Across all age groups, patients with depression featured the highest increments (from 11.9 to 42.0%). CONCLUSION: The risk for CD is substantially elevated in outpatients with PD when further neuropsychiatric symptoms are present. The data suggest that depression contributes equally to disability as does dementia.

Item Type: Paper
Uncontrolled Keywords: Aged Aged, 80 and over Ambulatory Care/statistics & numerical data Comorbidity Cross-Sectional Studies Dementia/diagnosis/*epidemiology/*nursing Depressive Disorder/diagnosis/*epidemiology/*nursing *Disability Evaluation Female Germany Health Surveys Humans Male Middle Aged Neurologic Examination Neuropsychological Tests *Nursing Assessment Parkinson Disease/diagnosis/*epidemiology/*nursing
Subjects: diseases & disorders > mental disorders > delirium dementia cognitive disorders
diseases & disorders > nervous system diseases and disorders > Parkinson's disease
diseases & disorders > mental disorders > mood disorders > depression
CSHL Authors:
Communities: CSHL labs > Henn lab
Depositing User: Matt Covey
Date: August 2011
Date Deposited: 06 Jun 2014 16:32
Last Modified: 06 Jun 2014 16:32
Related URLs:
URI: http://repository.cshl.edu/id/eprint/30276

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