Anxiety is associated with cognitive impairment in newly-diagnosed Parkinson's disease

Dissanayaka, Nadeeka N. W., Lawson, Rachael A., Yarnall, Alison J., Duncan, Gordon W., Breen, David P., Khoo, Tien K., Barker, Roger A. and Burn, David J. (2017) Anxiety is associated with cognitive impairment in newly-diagnosed Parkinson's disease. Parkinsonism and Related Disorders, 36 63-68. doi:10.1016/j.parkreldis.2017.01.001


Author Dissanayaka, Nadeeka N. W.
Lawson, Rachael A.
Yarnall, Alison J.
Duncan, Gordon W.
Breen, David P.
Khoo, Tien K.
Barker, Roger A.
Burn, David J.
Title Anxiety is associated with cognitive impairment in newly-diagnosed Parkinson's disease
Journal name Parkinsonism and Related Disorders   Check publisher's open access policy
ISSN 1353-8020
1873-5126
Publication date 2017-01-04
Sub-type Article (original research)
DOI 10.1016/j.parkreldis.2017.01.001
Open Access Status DOI
Volume 36
Start page 63
End page 68
Total pages 6
Place of publication London, United Kingdom
Publisher Elsevier
Language eng
Subject 2808 Neurology
2717 Geriatrics and Gerontology
2728 Clinical Neurology
Abstract Introduction Anxiety 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. Methods Patients 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. Results After 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. Conclusion This 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.
Formatted abstract
Introduction: Anxiety 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.

Methods: Patients 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.

Results: After 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.

Conclusion: This 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.
Keyword Anxiety
Mild cognitive impairment
Parkinson's disease
Cognitive subtypes
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ
Additional Notes Anxiety is associated with cognitive impairment in newly-diagnosed Parkinson's disease. Dissanayaka NN, Lawson RA, Yarnall AJ, Duncan GW, Breen DP, Khoo TK, Barker RA, Burn DJ; ICICLE-PD study group.. Parkinsonism Relat Disord. 2017 Jan 4. pii: S1353-8020(17)30001-9. doi: 10.1016/j.parkreldis.2017.01.001. [Epub ahead of print] PMID: 28108263 Free Article Similar articles

Document type: Journal Article
Sub-type: Article (original research)
Collections: UQ Centre for Clinical Research Publications
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Created: Fri, 27 Jan 2017, 17:34:59 EST by Nadeeka Dissanayaka on behalf of School of Psychology