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Mary Sano, PhD; Yaakov Stern, PhD; Janet Williams, DSW; Lucien Coté, MD; Ruth Rosenstein, MPh; Richard Mayeux, MD

Arch Neurol. 1989;46(12):1284-1286.

Abstract
• Dementia and depression in patients with Parkinson's disease have been reported separately, but their prevalence is controversial. This study examines the coexistence of these two problems and suggests a common underlying biochemical system. We examined these two entities by retrospective chart review and cerebrospinal fluid biochemistry. We found a prevalence of 10.9% for dementia, 51% for depression, and 5.4% for coincident depression and dementia. In a prospective study of patients with Parkinson's disease we found a continuum of cerebrospinal fluid 5-hydroxyindoleacetic acid concentrations. Patients who were either depressed or demented had lower concentrations of this metabolite than other patients with Parkinson's disease, but patients who were depressed and demented had the lowest levels. These results suggest that the coexistence of dementia and depression represents a unique clinical entity in Parkinson's disease. The serotonergic system may be involved in depression and dementia because evidence of a cumulative effect on this biochemical system is present.

Author Affiliations
From the Departments of Neurology (Drs Sano, Mayeux, Stern, Coté, and Rosenstein) and Psychiatry (Drs Mayeux, Stern, and Williams), College of Physicians and Surgeons, Columbia University, New York, NY.

Footnotes
Accepted for publication May 22, 1989.

Reprints not available.

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