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Abstract Background Depression, a prevalent non-motor symptom in Parkinson’s disease (PD), demonstrates complex associations with PD risk that remain incompletely characterized. This cross-sectional study investigates the consistency and non-linear dynamics of depression score-PD associations across Western (NHANES) and Asian (CHARLS) populations using standardized metrics (PHQ-9 and CESD-10). Methods We analyzed data from 34,308 U.S. (364 PD cases) and 19,395 Chinese participants (197 PD cases). Weighted multivariable logistic regression models assessed depression score-PD relationships adjusted for sociodemographic and clinical confounders. Non-linear relationships and threshold effects were examined via smooth curve fitting and segmented regression.ROC analysis compared the diagnostic accuracy of depression scales. Results Elevated depressive symptom scores were observed in PD cases versus controls (PHQ-9: 6.07 vs. 3.00; CESD-10: 12.63 vs. 8.56; both P
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