Objective: The aim of this longitudinal study is to examine which factors are associated with longitudinal changes in anxiety levels among individuals with Parkinson’s disease (PD).

Background: Anxiety is a common symptom in Parkinson’s disease, yet large longitudinal studies on the occurrence and possible risk factors for this condition in PD are lacking.

Methods: Analyses were performed in data of the SCOPA-PROPARK cohort, a 5-year hospital-based longitudinal cohort of over 400 PD patients who have been examined annually. Cross-sectional analyses were conducted to evaluate differences between patients with and without anxiety at baseline, while linear mixed models using data of all patients were used to identify factors associated with longitudinal changes in the scores on the anxiety domain of the Hospital anxiety and Depression Scale (HADS-A) scores. A survival analysis was performed using data of patients without anxiety at baseline to identify risk factors for the future development of anxiety. All analyses were performed twice by using two different cut-off points as proposed by the original developers of the HADS. (i.e. HADS-A ≥8 for possibly impaired and HADS-A≥11 for probably impaired).

Results: At baseline, 34 and 16% of patients had possible and probable anxiety (depending on cut-off used), while 38 and 20% of patients without this condition at baseline developed anxiety at some point during follow-up. Depression was the strongest predictor of anxiety in both cross-sectional and longitudinal analyses, probably due to the strong correlation between the two symptoms. Female gender, autonomic and cognitive dysfunction, poorer nighttime sleep and excessive daytime sleepiness (EDS) were associated with higher HADS-A scores over time. For both cut-off values, higher baseline HADS-A score was an independent predictor for future anxiety in the Cox proportional hazards model. Poorer nighttime sleep was only an independent predictor for future anxiety when a cut-off of ≥8 was applied, whereas EDS was only an independent predictor when a cut-off of ≥11 was applied.

Conclusions: Anxiety and depression are strongly correlated in PD. Patients with autonomic and cognitive dysfunction, poorer nighttime sleep and EDS are at increased risk to develop this symptom during the course of disease.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/anxiety-in-patients-with-parkinsons-disease/