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Depression in patients with early versus late onset of Parkinson's disease

From the Departments of Psychiatry and Behavioral Science (Drs. Starkstein, Berthier, and Robinson, and Ms. Bolduc), Neurology (Or. Preziosi), and Neurosciences (Dr. Robinson), Johns Hopkins University School of Medicine, Baltimore, MD; and the Institute of Neurological Research "Dr. Raul Carrea" (Dr. Berthier), Buenos Aires, Argentina.

We examined correlates of depression in patients whose onset of Parkinson's disease (PD) began before age 55 (early-onset group) compared with patients whose onset was after age 55 (late-onset group). The early-onset group showed a significantly higher frequency of depression than the late-onset group. When both groups were matched for duration of the disease, the early-onset group still showed a significantly higher frequency of depression, whereas tremor, akinesia, and rigidity were significantly more severe in the late-onset group. A stepwise regression analysis showed that in the early-onset group, depression scores were significantly correlated with scores of cognitive impairment and duration of the disease, while in the late- onset group, depression scores were significantly correlated with impairments in activities of daily living. These data suggest that depression in patients with early-onset PD may have a different etiology than in patients with late-onset PD.

Address correspondence and reprint requests to Dr. Starkstein, Meyer 4–119, Johns Hopkins Hospital, 600 North Wolfe Street, Baltimore, MD 21205.

Supported in part by NIH Research Scientist Development Award MH-00163 (R.G.R), NIH grants MH-40366, NS-15178, and NS-15080, a grant from the University of Buenos Aires (S.E.S), and a grant from the Institute Di Telia (M.L.B).

Received April 14, 1989. Accepted for publication in final form May 24, 1989.

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