Risk of Parkinson disease after depression

A nationwide population-based study

Cheng-Che Shen, MD,
Shih-Jen Tsai, MD,
Chin-Lin Perng, MD,
Benjamin Ing-Tiau Kuo, MD, PhD and
Albert C. Yang, MD, PhD

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Correspondence to Dr. Yang: accyang@gmail.com

Published online before print October 2, 2013, doi: 10.1212/WNL.0b013e3182a956ad Neurology 10.1212/WNL.0b013e3182a956ad

Abstract
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Abstract

Objective: To evaluate the risk of Parkinson disease (PD) among patients with depression by using the Taiwan National Health Insurance Research Database (NHIRD).

Methods: We conducted a retrospective study of a matched cohort of 23,180 participants (4,634 patients with depression and 18,544 control patients) who were selected from the NHIRD. Patients were observed for a maximum of 10 years to determine the rates of new-onset PD, and Cox regression was used to identify the predictors of PD. We also examined the risk of PD after excluding patients who were diagnosed with PD within 2 or 5 years after their depression diagnosis. A logistic regression model was used to identify risk factors associated with PD onset in patients with depression.

Results: During the 10-year follow-up period, 66 patients with depression (1.42%) and 97 control patients (0.52%) were diagnosed with PD. After adjusting for age and sex, patients with depression were 3.24 times more likely to develop PD (95% confidence interval 2.36–4.44, p < 0.001) compared with the control patients. After excluding patients who were diagnosed with PD within 2 or 5 years after their depression diagnosis, patients with depression had a higher hazard ratio for developing PD than the control patients. The odds ratios for age (1.09) and difficult-to-treat depression (2.18) showed that each is an independent risk factor for PD in patients with depression.

Conclusion: The likelihood of developing PD is greater among patients with depression than patients without depression. Depression may be an independent risk factor for PD.