Predictors of depressive symptoms among spouse caregivers in Parkinson's disease

The objective of this work was to determine the predictors of depressive sy mptoms among spouse caregivers of Parkinson's disease (PD) patients. Little is known about the strain in giving care to PD patients and how the motor, cognitive, and behavioral complications of PD contribute to depression amo ng spouse caregivers. Forty-five consecutive PD patients and their spouse caregivers agreed to be evaluated after a routine clinic visit. Patient demographic data and the p resence of hallucinations, delusions, incontinence, and sleep disturbances were obtained. The patients were assessed using the Unified Parkinson's Dis ease Rating Scale (UPDRS-motor section), Hoehn and Yahr (H&Y) staging, and the Mini-Mental State Examination (MMSE). Depressive symptoms were assessed using the 17-item Hamilton Depression Scale (HAMD-17) and the Beck Depress ion Inventory-II (BDI-II) on patients and spouses. Thirty men and 15 women had a mean age of 71.5 years (range 53-85), average PD duration of 10 years (range 1-26), a mean "on" H&Y stage of 2.8 and an MMSE mean score of 26 (range 13-30). There was good correlation between the HAMD-17 and the BDI-II scores in both patients (r = 0.69, P = 0.001) and s pouses (r = 0.66, P < 0.001). A moderate correlation was noted between the spouse HAMD-17 score and the patient UPDRS-motor score (r = 0.34; P = 0.02) , the age of PD onset (r = 0.33; P = 0.02) and patient HAMD-17 scores (r = 0.29; P = 0.05). A stronger correlation was noted between spouse HAMD-17 sc ores and the years of PD duration (r = 0.43; P = 0.003). There was a signif icant difference in the mean spouse HAMD-17 scores among PD patients with s leep disturbances versus those who did not (10.2 vs. 6.4; P = 0.04). Howeve r, on stepwise regression analysis, only the duration of PD remained signif icant (adjusted r = 0.17; P = 0.003). No difference was noted with hallucin ations, delusions or incontinence. We concluded that the duration of PD app ears to be the strongest predictor of depressive symptoms among spouse-care givers in this small cohort. (C) 2001 Movement Disorder Society.