Affective Disorders, Psychosis and Dementia in a Community Sample of Older Men with and without Parkinson's Disease.
BACKGROUND
Dementia and affective and psychotic symptoms are commonly associated with Parkinson's disease, but information about their prevalence and incidence in community representative samples remains sparse.


METHODS
We recruited a community-representative sample 38173 older men aged 65-85 years in 1996 and used data linkage to ascertain the presence of PD, affective disorders, psychotic disorders and dementia. Diagnoses followed the International Classification of Disease coding system. Age was recorded in years. Follow up data were available until December 2011.


RESULTS
The mean age of participants was 72.5 years and 333 men (0.9%) had PD at study entry. Affective and psychotic disorders and dementia were more frequent in men with than without PD (respective odds ratios: 6.3 [95%CI = 4.7, 8.4]; 14.2 [95%CI = 8.4, 24.0] and 18.2 [95%CI = 13.4, 24.6]). Incidence rate ratios of affective and psychotic disorders were higher among men with than without PD, although ratios decreased with increasing age. The age-adjusted hazard ratio (HR) of an affective episode associated with PD was 5.0 (95%CI = 4.2, 5.9). PD was associated with an age-adjusted HR of 8.6 (95%CI = 6.1, 12.0) for psychotic disorders and 6.1 (95%CI = 5.5, 6.8) for dementia. PD and dementia increased the HR of depressive and psychotic disorders.


CONCLUSIONS
PD increases the risk of affective and psychotic disorders, as well as dementia, among community dwelling older men. The risk of a recorded diagnosis of affective and psychotic disorders decreases with increasing age.
School of Psychiatry & Clinical Neurosciences, University of Western Australia, Perth, Australia.|WA Centre for Health & Ageing of Centre for Medical Research, Harry Perkins Institute of Medical Research, Perth, Australia.|Department of Psychiatry, Royal Perth Hospital, Perth, Australia.
Osvaldo P
OP
Almeida
WA Centre for Health & Ageing of Centre for Medical Research, Harry Perkins Institute of Medical Research, Perth, Australia.
Kieran
K
McCaul
School of Medicine and Pharmacology, University of Western Australia, Perth, Australia.|Department of Neurology, Sir Charles Gairdner Hospital, Perth, Australia.
Graeme J
GJ
Hankey
School of Medicine and Pharmacology, University of Western Australia, Perth, Australia.|Department of Endocrinology, Fiona Stanley Hospital, Perth, Australia.
Bu B
BB
Yeap
Queensland Research Centre for Peripheral Vascular Disease, College of Medicine and Dentistry, James Cook University, Townsville, Australia.|Department of Vascular and Endovascular Surgery, The Townsville Hospital, Townsville, Australia.
Jonathan
J
Golledge
WA Centre for Health & Ageing of Centre for Medical Research, Harry Perkins Institute of Medical Research, Perth, Australia.|School of Medicine and Pharmacology, University of Western Australia, Perth, Australia.|Department of Geriatric Medicine, Royal Perth Hospital, Perth, Australia.
Leon
L
Flicker
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