Objective: To determine the association of depression and anxiety, and their treatment, with patient-reported outcomes (PROs) in a large, online, observational cohort of people with Parkinson’s disease (PwP).
Background: Previously, we showed that both depression and anxiety are associated with worse functional ability and motor scores in a small cohort of newly diagnosed, untreated PwP. Additionally, there was a suggestion that starting treatment for depression and anxiety improved outcomes.1
Method: We analyzed data from PwP enrolled in Fox Insight, an online study that collects PROs longitudinally. Depression and anxiety were identified by self-reported diagnoses and symptoms using the 15-item Geriatric Depression Scale and Non-motor Symptoms Questionnaire item 17. Longitudinal regression models controlling for sociodemographics and disease duration evaluated the association between baseline depression and anxiety with quality of life (QoL) (PDQ-8), motor activities of daily living (UPDRS II), cognitive instrumental activities of daily living (ADLs) (PDAQ-15) and physical activity levels (PASE). Piecewise linear regression models examined the association between treatment initiation for depression and anxiety with PROs.
Results: 35,061 PwP (mean[SD] disease duration 5.2[6.0]; age 60.7[11.1]; 56% men) were analyzed. At baseline, 10,700 (31%) reported anxiety, with 5,240 (55%) receiving treatment; 10,292 (29.3%) reported depression, with 5,4719 (58%) receiving treatment. PwP with depression and anxiety had significantly worse quality of life, motor and cognitive ADLs, and physical activity levels at baseline and over time (all p-values <0.001), but differences did not increase over time. Amongst the smaller cohort of PwP who initiated treatment of depression and anxiety, a slowed rate of QoL worsening was observed for those with depression (slope change due to treatment β -3.06, CI [-4.83,-1.30], p<0.01) and both depression and anxiety (β -2.85, CI [-5.31, -0.38], p<0.05), but not anxiety only (β-0.28, CI [-1.11,-0.55], p=0.51).
Conclusion: Over 40% of PwP with depression and anxiety are untreated. At all points of disease, depression and anxiety is associated with worse patient-reported outcomes. Initiation of treatment for depression and both depression and anxiety is associated with improved QoL scores, which may be mediated by improvement in depressive symptoms.
References: 1. Shi Y, Dobkin R, Weintraub D, Cho HR, Caspell-Garcia C, Bock M, Brown E, Aarsland D, Dahodwala N. Association of Baseline Depression and Anxiety with Longitudinal Health Outcomes in Parkinson’s Disease. Mov Disord Clin Pract. 2024 Sep;11(9):1103-1112. doi: 10.1002/mdc3.14145.
To cite this abstract in AMA style:
N. Dahodwala, C. Hurley, T. Kapogiannis, H. Cho, C. Caspell-Garcia, D. Weintraub, R. Dobkin. The Role of Depression and Anxiety in the Progression of Parkinson’s Disease [abstract]. Mov Disord. 2025; 40 (suppl 1). https://www.mdsabstracts.org/abstract/the-role-of-depression-and-anxiety-in-the-progression-of-parkinsons-disease/. Accessed October 5, 2025.« Back to 2025 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/the-role-of-depression-and-anxiety-in-the-progression-of-parkinsons-disease/