Objective: To analyze longitudinal trends of severity of anxiety and depression in a large Parkinson’s Disease (PD) cohort

Background: •Depression and anxiety are common non motor symptoms in PD. The few published longitudinal studies on these symptoms in PD are limited by small sample size and brief follow-up. Patterns in severity of depression/ anxiety over longer time periods are unknown.

Method: 615 PD patients during sequential visits between 2014 and 2022. Anxiety and depression were measured using the Patient-Reported Outcome Measurement Information System (PROMIS-29)1. Based on T-scores, PD patients were categorized into 3 subgroups and at 2 and 4 years later.

T score < 55: No depression, no anxiety.

T score 55-60: Mild depression, mild anxiety.

T score > 60: Moderate to severe depression and anxiety.

Results: At baseline, 74% of patients had no depression, 16% mild, 10% moderate/severe; 69% had no anxiety, 16% mild, 15% moderate/severe. Over time, the proportion of patients without depression or anxiety decreased (2 years: depression 69%, anxiety 59%; 4 years: depression 64%, anxiety 55%), while the frequency of patients with some degree of depression or anxiety increased accordingly. For both depression and anxiety, most patients in the non-symptomatic (67-82%) and moderately/severely affected groups (55-64%) did not change category at follow-up. Patients with mild depression at baseline split evenly into all 3 categories after 2 years, with more shifting towards moderate/severe depression after 4 years. Likewise, the proportion of patients with mild anxiety that were re-categorized as moderate/severe anxiety increased from 24% after 2 years to 41% after 4 years.

Conclusion: The prevalence of both depression and anxiety in a large PD cohort increases over time. Most patients with either no or moderate/severe depression or anxiety remain in their baseline category. In contrast, patients with mild depression or anxiety at baseline show more variability in the severity of their mental health symptoms over time.

Fig 1 Trends of depression in PD

Fig 2 Trends of Anxiety in PD

References: 1. Kroenke K, Stump TE, Chen CX, Kean J, Bair MJ, Damush TM, Krebs EE, Monahan PO. Minimally important differences and severity thresholds are estimated for the PROMIS depression scales from three randomized clinical trials. J Affect Disord. 2020 Apr

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MDS Abstracts - https://www.mdsabstracts.org/abstract/longitudinal-patterns-of-anxiety-and-depression-in-patients-with-parkinsons-disease/