Objective: To examine the prevalence of fear of progression (FoP) in Parkinson’s disease (PD) patients, and to analyze which sociodemographic, clinical and neuropsychological factors are associated with FoP in PD.

Background: FoP is a reactive and conscious fear that appears either as a reaction to the diagnosis of a progressive disease or during the course of a progressive disease. So far, only one study exists examining FoP in PD (n=54) in comparison to other chronic diseases. This study demonstrated that PD patients show the second highest FoP scores.

Method: Within a multicenter cross-sectional study, 111 PD patients (age: 65.01±9.22; ♂: 58.6%; ♀: 41.4%; years of education: 14.73±3.40; UPDRS-III: 28.87±16.68; MoCA: 24.79±3.27; HADS-D: 5.08±3.63) in three German rehabilitation centers were examined regarding their FoP, operationalized with an established self-reporting questionnaire (max. 170 points). Cut off scores are lacking, thus, we used the mean score ± SD of this PD sample to determine cut offs for low, moderate and high FoP as suggested in previous studies. Further sociodemographic, clinical, cognitive and psychiatric parameters were examined as well. Descriptive and Pearson correlation analyses were performed using IBM SPSS Statistics 26.

Results: The mean sum score of the FoP questionnaire is 69.71±18.03, while 18.0% of the patients (n=20) showed low FoP, 49.5% (n=55) moderate FoP, and 32.4% (n=36) high FoP. A negative correlation with FoP and years of education (r=-.279; p=003) could be demonstrated, indicating that those patients with fewer years of education showed more FoP. Additionally, a positive correlation with the FoP and the anxiety (r=.540, p=.000) and the depression score (r=.632, p=.000) of the HADS scale indicates that FoP is significantly associated with higher symptoms of anxiety and depression. Finally, more FoP is highly correlated with a poorer quality of life as measured with the PDQ-8 (r=.503, p=.000).

Conclusion: With more than 80% of this PD sample showing moderate to high FoP, this study demonstrates that FoP is a frequently occurring symptom in PD that is significantly associated with psychiatric symptoms and lower quality of life. Thus, there is an urgent need for further research in this field and the clinical implementation of psychotherapeutic approaches to deal with emotional responses that are linked to the disease progress.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/fear-of-progression-in-parkinsons-disease-preliminary-results-of-a-pilot-cross-sectional-study/