Motor dysfunction in late life depression: A mood or movement disorder?

AIMS: motor dysfunction, presenting as an altered quantity or quality of movements, is common in late life depression (LLD) but poorly understood. We characterized motor dysfunction with a multimodal clinical-experimental assessment and investigated associations with depressive symptoms, psychotropic medication and falls.

METHODS

75 participants ≥60 yr., 34 patients with LLD and 41 healthy controls, from the Leuven LLD study completed affective, cognitive and motor assessments including the Montgomery-Åsberg Depression Rating Scale (MADRS), Apathy Evaluation Scale, mini-mental state examination, neuropsychological battery, parkinsonism scale (MDS-UPDRS part III), ataxia scale (SARA), speech and gait analysis. A digital tablet drawing task tracked how fast patients initiated and executed movements with variable complexity and cueing. Past year fall history was collected. Multiple linear regression analyses evaluated associations of motor outcome with assessments scores, depending on diagnostic group, with age, exercise frequency, education duration as covariates. Movement initiation and execution were investigated with linear mixed models including the same covariates. Psychotropic medication effects and statistical predictors of falls were analyzed in patients.

RESULTS

patients (mean age 73.3 ± SD6.0 yr., MADRS 27.9 ± 11.1, 42 % fall incidence) performed worse than controls on all motor assessments which was overall not significantly associated with depression severity, apathy, cognitive dysfunction, antipsychotic or benzodiazepine use. Patients executed movements slower than controls, but movement initiation was similar if cueing was provided. Patients' SARA and gait outcome related to past year fall incidence.

CONCLUSION

motor dysfunction in LLD patients was not clearly related to core depressive symptoms or cognitive dysfunction. Cueing may facilitate movement initiation in LLD.

STUDY REGISTRATION: NCT03849417.