{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T17:49:34Z","timestamp":1793382574965,"version":"4.5.0"},"reference-count":22,"publisher":"American Medical Association (AMA)","issue":"8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"<jats:sec id=\"ab-zoi230797-4\"><jats:title>Importance<\/jats:title><jats:p>Caregivers are integral to Parkinson disease (PD) care, but little information exists regarding how caregivers impact patient outcomes.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi230797-5\"><jats:title>Objective<\/jats:title><jats:p>To assess the association between caregivers reporting depression symptoms and patient quality of life (QOL), emergency department (ED) visits, and hospitalizations.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi230797-6\"><jats:title>Design, Setting, and Participants<\/jats:title><jats:p>This retrospective cohort study was conducted at 15 Parkinson\u2019s Foundation Centers of Excellence within the US. The Parkinson\u2019s Foundation Parkinson Outcomes Project registry was used to collect baseline data from January 1, 2016, to December 31, 2018, with subsequent annual study visits through July 31, 2020. Data were analyzed from August 5, 2020, to June 9, 2023. A convenience sample of 454 patients with PD and their caregivers was recruited during routine clinical visits with movement disorder specialists. Patients with a physician diagnosis of idiopathic PD who lived at home and had 1 or more follow-up study visits were included.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi230797-7\"><jats:title>Exposure<\/jats:title><jats:p>Caregiver depression symptoms using the Center for Epidemiologic Studies Depression Scale.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi230797-8\"><jats:title>Main Outcomes and Measures<\/jats:title><jats:p>Patient health-related QOL (measured by the 39-item Parkinson Disease Questionnaire), number of annual ED visits, and number of annual hospitalizations were measured. The independent association between caregivers reporting depression symptoms and patient outcomes was assessed using linear mixed-effects and Poisson regression models. The a priori hypotheses were that a greater number of depression symptoms reported via the Center for Epidemiologic Studies Depression Scale would be associated with worse patient QOL and a greater number of ED visits and hospitalizations.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi230797-9\"><jats:title>Results<\/jats:title><jats:p>Among 454 patient-caregiver dyads (patients: mean [SD] age, 67.3 [8.4] years; 320 men [70.5%]; caregivers: mean [SD] age, 65.9 [8.7] years; 326 women [71.8%]), the mean (SD) follow-up was 2.0 (1.4) study visits. Greater depression symptoms among caregivers were associated with worse patient QOL as measured by the Parkinson Disease Questionnaire (mean [SD] score, 33.78\u2009[17.71], on a scale of 0-100, with higher scores indicating worse QOL, among patients with caregivers who had depression symptoms vs 24.50 [14.19] among patients with caregivers who did not have depression symptoms; \u03b2\u2009=\u20090.43; 95% CI, 0.28-0.58; <jats:italic>P<\/jats:italic>\u2009&amp;amp;lt;\u2009.001) and more annual ED visits (\u03b2\u2009=\u20090.02; 95% CI, 0 to 0.04; <jats:italic>P<\/jats:italic>\u2009=\u2009.03) but not more hospitalizations (\u03b2\u2009=\u20090.02; 95% CI, \u22120.01 to 0.03; <jats:italic>P<\/jats:italic>\u2009=\u2009.10).<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi230797-10\"><jats:title>Conclusions and Relevance<\/jats:title><jats:p>In this cohort study, patients with PD who had caregivers at higher risk of depression were more likely to have worse QOL and higher ED use than patients who had caregivers not at higher risk of depression. Additional caregiving resources and interventions to reduce caregiver depression symptoms could potentially improve patient outcomes.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2023.27485","type":"journal-article","created":{"date-parts":[[2023,8,11]],"date-time":"2023-08-11T15:31:10Z","timestamp":1691767870000},"page":"e2327485","source":"Crossref","is-referenced-by-count":21,"title":["Association of Caregiver Depression Risk With Patient Outcomes in Parkinson Disease"],"prefix":"10.1001","volume":"6","author":[{"given":"Rudmila","family":"Rashid","sequence":"first","affiliation":[{"name":"Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Whitley W.","family":"Aamodt","sequence":"additional","affiliation":[{"name":"Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Horn","sequence":"additional","affiliation":[{"name":"Department of Neurology, The University of Texas Health Science Center at San Antonio, San Antonio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nabila","family":"Dahodwala","sequence":"additional","affiliation":[{"name":"Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia"},{"name":"Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","published-online":{"date-parts":[[2023,8,11]]},"reference":[{"key":"zoi230797r1","author":"Hassan","year":"2012"},{"key":"zoi230797r2","author":"Aarsland","year":"2009"},{"issue":"6","key":"zoi230797r3","doi-asserted-by":"publisher","first-page":"823","DOI":"10.1016\/j.socscimed.2011.01.015","article-title":"Family presence 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Data now available: annual Parkinson\u2019s Outcomes Project (POP). Moving Along. September 2022. Accessed June 23, 2023. https:\/\/www.movementdisorders.org\/MDS\/Moving-Along\/2022-issue-3\/POP-data"},{"key":"zoi230797r11","unstructured":"Carer Inclusive Working Group for ISO 25551. Terminology related to caregiving: an informative guide to commonly used concepts, words and phrases. International Standards Organization. Accessed June 23, 2023. https:\/\/committee.iso.org\/files\/live\/sites\/tc314\/files\/Terminology%20related%20to%20caregiving%20free%20resource.pdf"},{"key":"zoi230797r15","unstructured":"Food and Drug Administration; Center for Drug Evaluation and Research; Center for Biologics Evaluation and Research. Patient-focused drug development: collecting comprehensive and representative input. US Dept of Health and Human Services. June 2020. 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