Objective: To determine the demographic, clinical and cognitive features associated with anxiety disorders in Parkinson’s disease (PD).

Background: The point prevalence of anxiety disorders in PD patients is 31%. Anxiety has a negative impact on quality of life and both motor and non-motor symptoms, and may lead to an increase in medication use. However, there are little data on the clinical and cognitive characteristics of PD patients suffering from anxiety disorders.

Method: Non-demented PD patients were enrolled from two movement disorders clinics in Europe (Lille and Maastricht). Demographic (age, sex, personal and family history), clinical (MDS-UPDRS, disease duration, medication), neuropsychiatric (depression, anxiety, apathy, hallucinations) and cognitive (overall efficiency, memory, attention and executive functions, language, visuospatial functions) data were recorded. Patients were diagnosed with anxiety disorders based on a cut-off score on the Parkinson Anxiety Scale. Between group comparisons were carried out with appropriate tests.

Results: We included 118 patients: 34 with and 84 without anxiety disorders. Patients with an anxiety disorder were more often women (OR: 2.84; 95% CI: 1.23-6.58; p = 0.013) and more often had a family history of PD (OR: 3.42; 95% CI: 1.47-7.96; p = 0.003). In anxious patients, the levodopa equivalent daily dose was higher (937.36 vs 732.53 mg; p = 0.02) and they used antidepressants (OR: 12.38; 3.66-41.91; p < 0.0001) and/or anxiolytic drugs (OR: 17.08; 95% CI: 3.5-83.33; p < 0.0001) more frequently. Anxious patients had a more advanced disease stage (median Hoehn & Yahr, p = 0.003) and scores on the depression, anxiety, sleep disorders, pain and fatigue items of the MDS-UDRS were all significantly higher in the anxious group. This group also had significantly lower scores for overall cognitive efficiency, attention and executive functions.

Conclusion: Anxiety disorders in PD are associated with higher drug use and more severe motor and non-motor symptoms. In addition, patients with anxiety disorders have more impaired in attention and executive functions. The underlying mechanisms need to be further investigated.

References: [1] Leentjens, A. F. G. et al. Symptomatology and markers of anxiety disorders in Parkinson’s disease: a cross-sectional study. Mov. Disord. 26, 484–492 (2011). [2] Leentjens, A. F. G. et al. The Parkinson Anxiety Scale (PAS): development and validation of a new anxiety scale. Mov. Disord. 29, 1035–1043 (2014).

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MDS Abstracts - https://www.mdsabstracts.org/abstract/clinical-and-cognitive-features-of-anxiety-in-parkinsons-disease/