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Major depressive disorder, Alzheimerâ€™s, and Parkinsonâ€™s disease are among the leading causes of dementia in the elderly. These diseases are often misdiagnosed because of overlapping symptoms. This study aimed to evaluate whether neutrophil-to-lymphocyte ratio, which has been used as an indicator of systemic inflammation, can be used for the differential diagnoses of these diseases.  Materials and Method: A total of 95 patients with major depressive disorder, Alzheimerâ€™s, or Parkinsonâ€™s disease were enrolled. Blood specimens were drawn from participants and neutrophil-to-lymphocyte ratios were calculated. We compared the three groups according to mean neutrophil-to-lymphocyte ratio and mean neutrophil-to-lymphocyte ratio adjusted for age. We used the Receiver Operating Characteristics curve analysis to predict the sensitivity and specificity of this ratio for the differential diagnosis between depression and Alzheimerâ€™s disease.  Results: The mean neutrophil-to-lymphocyte ratio for the depression, Alzheimerâ€™s, and Parkinsonâ€™s disease groups was 2.2 Â± 0.7, 2.9 Â± 1.2, and 2.2 Â± 0.9, respectively (P = 0.005). The adjusted mean neutrophil-to-lymphocyte ratio for age for the depression, Alzheimerâ€™s, and Parkinsonâ€™s disease groups was 2.2 Â± 0.17, 2.8 Â± 0.15, and 2.2 Â± 0.2, respectively (P = 0.025). Receiver Operating Characteristics curve analyses predicted that the sensitivity and specificity for the differential diagnosis between depression and Alzheimerâ€™s disease was 54.8% and 80%, respectively.  Conclusion: This study suggested that a simple arithmetic calculation could help clinicians in the differential diagnosis between depression, Alzheimerâ€™s, and Parkinsonâ€™s disease. Neutrophil-to-lymphocyte ratio can be used as a secondary line of evidence, along with the initial clinical assessment.

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Neutrophil-to-lymphocyte ratio as a potential differential diagnostic marker for Alzheimer’s disease, major depressive disorder, and Parkinson’s disease