10 research outputs found
Suicidal ideation in a European Huntington's disease population
BACKGROUND: Previous studies indicate increased prevalences of suicidal ideation,
suicide attempts, and completed suicide in Huntington's disease (HD) compared
with the general population. This study investigates correlates and predictors of
suicidal ideation in HD.
METHODS: The study cohort consisted of 2106 HD mutation carriers, all
participating in the REGISTRY study of the European Huntington's Disease Network.
Of the 1937 participants without suicidal ideation at baseline, 945 had one or
more follow-up measurements. Participants were assessed for suicidal ideation by
the behavioural subscale of the Unified Huntington's Disease Rating Scale
(UHDRS). Correlates of suicidal ideation were analyzed using logistic regression
analysis and predictors were analyzed using Cox regression analysis.
RESULTS: At baseline, 169 (8.0%) mutation carriers endorsed suicidal ideation.
Disease duration (odds ratio [OR]=0.96; 95% confidence interval [CI]: 0.9-1.0),
anxiety (OR=2.14; 95%CI: 1.4-3.3), aggression (OR=2.41; 95%CI: 1.5-3.8), a
previous suicide attempt (OR=3.95; 95%CI: 2.4-6.6), and a depressed mood
(OR=13.71; 95%CI: 6.7-28.0) were independently correlated to suicidal ideation at
baseline. The 4-year cumulative incidence of suicidal ideation was 9.9%.
Longitudinally, the presence of a depressed mood (hazard ratio [HR]=2.05; 95%CI:
1.1-4.0) and use of benzodiazepines (HR=2.44; 95%CI: 1.2-5.0) at baseline were
independent predictors of incident suicidal ideation, whereas a previous suicide
attempt was not predictive.
LIMITATIONS: As suicidal ideation was assessed by only one item, and participants
were a selection of all HD mutation carriers, the prevalence of suicidal ideation
was likely underestimated.
CONCLUSIONS: Suicidal ideation in HD frequently occurs. Assessment of suicidal
ideation is a priority in mutation carriers with a depressed mood and in those
using benzodiazepines
Clinical and genetic characteristics of late-onset Huntington's disease
Background: The frequency of late-onset Huntington's disease (>59 years) is assumed to be low and the clinical course milder. However, previous literature on late-onset disease is scarce and inconclusive. Objective: Our aim is to study clinical characteristics of late-onset compared to common-onset HD patients in a large cohort of HD patients from the Registry database. Methods: Participants with late- and common-onset (30\u201350 years)were compared for first clinical symptoms, disease progression, CAG repeat size and family history. Participants with a missing CAG repeat size, a repeat size of 6435 or a UHDRS motor score of 645 were excluded. Results: Of 6007 eligible participants, 687 had late-onset (11.4%) and 3216 (53.5%) common-onset HD. Late-onset (n = 577) had significantly more gait and balance problems as first symptom compared to common-onset (n = 2408) (P <.001). Overall motor and cognitive performance (P <.001) were worse, however only disease motor progression was slower (coefficient, 120.58; SE 0.16; P <.001) compared to the common-onset group. Repeat size was significantly lower in the late-onset (n = 40.8; SD 1.6) compared to common-onset (n = 44.4; SD 2.8) (P <.001). Fewer late-onset patients (n = 451) had a positive family history compared to common-onset (n = 2940) (P <.001). Conclusions: Late-onset patients present more frequently with gait and balance problems as first symptom, and disease progression is not milder compared to common-onset HD patients apart from motor progression. The family history is likely to be negative, which might make diagnosing HD more difficult in this population. However, the balance and gait problems might be helpful in diagnosing HD in elderly patients