Abstract
IntroductionAnxiety and mild cognitive impairment (MCI) are prevalent non-motor manifestations of Parkinson's disease (PD). While few studies have demonstrated a possible link between cognitive dysfunction and anxiety in PD, to our knowledge, no studies have directly examined the association between them. This study investigated the association between anxiety and cognitive deficits in newly diagnosed PD patients. MethodsPatients with newly diagnosed PD (N = 185) were recruited from community and outpatient clinics. Anxiety was assessed using the Unified Parkinson's Disease Rating Scale (MDS-UPDRS) clinician rated anxiety item, which has previously been validated against a standardized criteria for the diagnosis of anxiety disorders in PD. Participants scoring ≥2 were classified as anxious. A threshold of 1 SD below normative values (obtained from controls) was used to define cognitive impairment. Impairments in specific cognitive domains were identified as being >1 SD below controls in ≥1 test per domain. ResultsAfter controlling for age, education and motor severity, patients with anxiety were three times more likely to have cognitive impairment compared to those without anxiety (OR = 3.0, 95% CI = 1.2–7.3, p < 0.05). Patients with anxiety were more than twice as likely to be classified as having cognitive impairment due to impairment in the memory domain compared with PD without anxiety (OR = 2.3, 95% CI = 1.0–5.1, p < 0.05), whilst no associations were found between anxiety and performance on other cognitive domains. ConclusionThis study shows an association between anxiety and cognitive impairment (specifically memory impairment). Examining the neural basis of this association warrants future research in this developing field.
Highlights
Anxiety and mild cognitive impairment (MCI) are prevalent non-motor manifestations of Parkinson's disease (PD)
This study investigated the role of anxiety in cognitive impairment, and the cognitive domains affected in this latter state in newly diagnosed PD
A further 27 participants did not complete the anxiety item of the MDS-UPDRS as it was introduced after the study had commenced and were excluded from the analysis, leaving 185 PD participants
Summary
Anxiety and mild cognitive impairment (MCI) are prevalent non-motor manifestations of Parkinson's disease (PD). This study investigated the association between anxiety and cognitive deficits in newly diagnosed PD patients. Patients with anxiety were more than twice as likely to be classified as having cognitive impairment due to impairment in the memory domain compared with PD without anxiety (OR 1⁄4 2.3, 95% CI 1⁄4 1.0e5.1, p < 0.05), whilst no associations were found between anxiety and performance on other cognitive domains. There are no studies that have directly examined the relationship between these two primary neuropsychological complaints in newly diagnosed PD patients. Such an approach would be useful in the clinical management of these non-motor symptoms and the identification of neuropsychological subtypes in PD. It has been suggested that cognitively impaired PD patients are more likely to use anti-anxiety medication than those without [5] and that pharmacological treatment of PD-MCI using rivastigmine has been shown to reduce concomitant anxiety [6]
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