Abstract
BACKGROUND: Parkinson's disease (PD) and depression frequently coexist in middle-aged and older populations, potentially influencing each other. This study explores the relationship between depression and PD risk and investigates the association between lifestyle score and PD risk. METHODS: Data from the China Health and Retirement Longitudinal Study (CHARLS) for adults aged 45 and above were analyzed. A total of 30,347 participants were included, with 565 individuals developing PD during follow-up. PD cases were self-reported physician diagnoses. Depression was assessed using the CESD-10 scale (score ≥ 10 indicating depression). Lifestyle factors (smoking, drinking, social activity, sleep, and BMI) were scored as healthy (≥4) or unhealthy (<4). Cox proportional hazards models were used to analyze PD risk, and cubic spline regression was employed to evaluate the dose-response relationship between depression, lifestyle, and PD risk. RESULTS: Depression (CESD-10 ≥ 10) was significantly associated with an increased risk of PD. In the fully adjusted model (Model 4), individuals with depression had a 53% higher risk of developing PD compared to those without depression (HR = 1.53, 95% CI: 1.28-1.83). Cubic spline regression revealed a dose-response relationship: as CESD-10 scores increased, the risk of PD also increased. Unhealthy lifestyle was significantly associated with a higher risk of PD. The analysis showed that individuals with an unhealthy lifestyle had a 23.5% higher risk of developing PD than those with a healthy lifestyle. Additionally, the risk of PD varied with different lifestyle components. For example, no-smoking had a 17.9% lower risk of developing PD compared to smoking, and individuals with long sleep durations had a 36.2% lower risk of PD compared to those with short sleep durations. CONCLUSION: Depression is significantly associated with the risk of PD in middle-aged and older populations. Our findings show a strong link between an unhealthy lifestyle and PD risk. This highlights the importance of addressing depression and avoiding unhealthy lifestyles in PD prevention.