Objective: This study investigated the relationship between anxiety and cognitive impairment in PD.

Background: Anxiety and cognitive impairment are prevalent non-motor complications in PD. The average prevalence of anxiety is 31%, while 80% of advanced PD patients develop dementia. Recent evidence suggests higher anxiety rates in newly diagnosed PD with mild cognitive impairment (MCI)¹. This study further evaluates this relationship in PD using standardized measures of anxiety and MCI. 

Methods: Thirty (N=30) PD patients were examined for anxiety according to the Diagnostic and Statistical Manual of Mental Disorders 5^th edition (DSM-5) criteria and for cognitive impairment using a comprehensive neuropsychological test battery based on standard criteria². Deficits in specific cognitive domains were identified when a patient scored ≥1SD below normative values on ≥1 test, and MCI was classified when a patient scored ≥1SD below normative values on ≥2 tests.

Results: Twelve patients (40%) had an anxiety disorder and 20 patients (66.7%) had MCI. Twenty-eight patients (93.3%) were impaired in ≥1 cognitive test with impairments in attention and memory being the most common; 22 patients (73.3%) were impaired in ≥1 test assessing attention, and 16 (53.3%) in ≥1 test assessing memory. Seven patients (23.3%) had both an anxiety disorder and MCI. Of patients that had an anxiety disorder (n=12), 7 were impaired in ≥1 test assessing attention, 4 in ≥1 test of memory, 3 in ≥1 test of language, 1 in ≥ 1 test of executive function, and none in a test of visuospatial function.

Conclusions: The frequency of comorbid anxiety and MCI found in this study (23.3%) is higher than reports in non-PD populations (10%), highlighting the importance of examining the association in PD. Deficits in attention and memory were the most common in this PD patient sample, and in those with a DSM-5 anxiety disorder. Further research in a larger sample size is required to further understand the association between anxiety and cognitive subtypes in PD. This has the potential to aid identification of PD subtypes for targeted treatment, and development of synergistic treatments, enhancing PD patient’s quality of life.

References: ¹Dissanayaka et al. 2017 Parkinsonism & Rel Disord

²Litvan et al., 2012 Mov Disord

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MDS Abstracts - https://www.mdsabstracts.org/abstract/investigating-the-association-between-anxiety-and-cognitive-impairment-in-parkinsons-disease-a-descriptive-study/