Sestre Milosrdnice University hospital and Institute of Clinical Medical Research
Abstract
Parkinson’s disease (PD) is a neurodegenerative disorder causing not only motor dysfunction but also cognitive, psychiatric, autonomic and sensory disturbances. Depression is the most common psychiatric disturbance identified in patients with PD and has been shown to be more common in PD than in other chronic and disabling disorders, occurring in approximately 40% of PD patients. However, the prevalence and clinical features associated with depression in PD remain controversial. Dementia is increasingly recognized as a symptom associated with idiopathic PD, and is found in up to 40% of all patients suffering from that condition. The aim of this study was to estimate the prevalence of depressive and dementia symptoms in PD patients. The study included 35 consecutive patients with PD, 13 (37.4%) male and 22 (62.6%) female (mean age 62.9}11.0, range 36-85 years), mean duration of disease 4.7}2.9 (range 1-10) years, hospitalized during one year at Clinical Department of Neurology, Tuzla University Clinical Center, Tuzla, Bosnia and Herzegovina. The Mini Mental State Examination (MMSE) was used for assessment of cognitive deterioration and Beck Depression Inventory (BDI) for depression. Computerized tomography was performed in all patients. According to BDI scale, depressive symptoms were present in all 35 PD patients: minimal in 4 (11.4%), low in 7 (20%), moderate in 8 (22.8%), severe in 9 (25.4%) and extreme in 7 (20%) patients. On MMSE scale, 9 (25.4%) patients were free from cognitive deterioration and 26 (74.6%) patients had moderate to severe deterioration, but 21 (60%) patients (7 (33.33%) male and 14 (66.66%) female) had symptoms of dementia (MMSE score ≤23). Using MMSE scale, 8 (22.8%) patients were free from dementia and 27 (77.2%) patients had some cognitive deterioration. Very mild symptoms of dementia were found in 6 (25.9%) and overt features of dementia in 21 (74.1%) PD patients. So, out of 35 PD study patients, 21 (60%) (7 (33.3%) male and 14 (66.7%) female) had symptoms of dementia (MMSE score ≤23). In conclusion, depressive and dementia symptoms arecommon in PD patients.Parkinsonova bolest (PB) je neurodegenerativna bolest koja uzrokuje ne samo motorne nego i kognitivne, psihijatrijske, autonomne i senzorne poremećaje. Depresija je najrašireniji psihijatrijski poremećaj koji se identificira kod PB. Pokazano je da je rašireniji u PB (pojavljuje se u oko 40% bolesnika) nego u drugim kronično onesposobljavajućim bolestima. Međutim, učestalost i klinička prezentacija depresivnosti u PB su još uvijek na neki način kontroverzna podoručja. Nadalje, demencija se sve više prepoznaje kao simptom udružen s idiopatskom PB. Njezino pojavljivanje utvrđeno je u oko 40% ovih bolesnika. Cilj je ove studije bio utvrditi učestalost depresivnih i dementnih simptoma u PB. Analizirano je 35 bolesnika s PB, 13 (37.41%) muškog i 22 (62.49%) ženskog spola (prosječene dobi 62.9}11.3 godine, raspon 36-85 godina), prosječnog trajanja bolesti od 4.7}2.9 godina (raspon 1-10 godina), koji su bili hospitalizirani u jednogodišnjem razdoblju na Klinici za neurologiju Univerzitetskoga kliničkog centra u Tuzli (Bosna i Hercegovina). Za procjenu kognitivne deterioracije korišten je upitnik za Mini Mental Status (MMS), a za depresiju Beckova ljestvica za depresiju. Kod svih bolesnika je napravljena kompjutorizirana tomografija mozga. Prema Beckovoj ljestvici za depresiju, depresivni su simptomi bili prisutni u svih 35 ispitivanih bolesnika s PB: minimalno u 4 (11.4%), nisko u 7 (20%), umjereno u 8 (22.8%), teško u 9 (25.4%) i naglašeno u 7 (20%) bolesnika. Prema ljestvici MMS, bez kognitivne deterioracije je bilo 8 (22.8%), a sa stanovitim kognitivnim poremećajem 27 (77.2%) bolesnika. S umjerenom kognitivnom deterioracijom je bilo 6 (25.9%) bolesnika, a s jasnim znacima demencije 21 (74.1%) bolesnik s PB. Dakle, od 35 analiziranih PB bolesnika simptomi demencije (MMS ≤23) utvrđeni su u 21 (60%) bolesnika (muškaraca 7 ili 33.3%, žena 14 ili 66.7%). U zaključku, depresivni i dementni simptomi su rašireni u Parkinsonovoj bolesti
