Anxiety, Depression, and Apathy as Predictors of Cognitive Decline in Patients With Parkinson's Disease—A Three-Year Follow-Up Study

Abstract

ObjectiveAnxiety, depression, and apathy are the most common neuropsychiatric symptoms in Parkinson's disease (PD) patients. They impair cognitive functioning and have a profound impact on quality of life. This follow-up study aims to investigate the predictive value of anxiety, depression, and apathy on the development of Mild Cognitive Impairment (MCI) in PD patients.MethodsTwenty-nine cognitively unimpaired PD patients (mean age 68.2 SD ± 7.12 years; 13 women) participated in this study. At Baseline (BL) levels of apathy (Apathy Evaluation Scale, AES), depression (Beck Depression Inventory, BDI-II), and anxiety (Beck Anxiety Inventory, BAI), were assessed. Cognitive status was reassessed three years later according to MCI/non-MCI status. For statistics, we used binary logistic regression and receiver operating characteristic curve (ROC) analysis to examine anxiety, apathy, and depression at BL as a predictor of MCI status three years later.ResultsEight of the 29 patients developed MCI. Anxiety level at BL was found to predict MCI status at three-year follow-up (OR = 1.20, CI = 1.02–1.41, p = 0.02), while depression (OR = 1.16, CI = 0.93–1.47, p = 0.20) and apathy (OR = 1.06, CI = 0.92–1.23, p = 0.40) did not predict MCI status. The area under the ROC curve (AUC) of BAI for discriminating PD-non-MCI from PD-MCI was 0.79 (CI = 0.61–0.98). The optimal classification threshold yielded a sensitivity of 75.0 % and a specificity of 76.2 %. Neither apathy nor depression at BL discriminated between PD-non-MCI patients from PD-MCI three years later.ConclusionsThis study shows an association between anxiety and the development of MCI in PD patients, although the association between apathy, depression, and MCI did not reach a significant level.

Health‐related quality of life and mild behavioral impairment in older adults without dementia

“…Previous studies have demonstrated that depressive symptoms, assessed using the GDS, were significantly correlated with reduced HR‐QoL in people with AD, 16–18 vascular dementia, 42 mixed dementia, and MCI 12 . Of importance, depression in older adults increases risk for the development of dementia and it has been indicated as a modifiable risk factor 43 ; anxiety symptoms may predict MCI development 44 . Regarding reduced motivation in MBI‐C, it reflects a loss of interest or spontaneous involvement in social interactions, life activities, and goal‐oriented behaviors, corresponding to apathy in PWDs.…”

“…12 Of importance, depression in older adults increases risk for the development of dementia and it has been indicated as a modifiable risk factor 43 ; anxiety symptoms may predict MCI development. 44 Regarding reduced motivation in MBI-C, it reflects a loss of interest or spontaneous involvement in social interactions, life activities, and goal-oriented behaviors, corresponding to apathy in PWDs. Apathy is associated with reduced HR-QoL in PWDs, 13,15,17 and it was shown to be associated with more than 2-fold increased risk of progression to cognitive impairment in the cognitively normal population and people with MCI.…”

The biogeography of colonial volvocine algae in the Yangtze River basin

“…The categorical variable data do not necessarily have a linear relationship with the scaled data, so the Eta-squared value was used as the correlation coefficient to determine the correlation between the existence of CVA and environmental factors, the Eta-squared values of 0.14, 0.06, and 0.01 were considered a strong, moderate, and weak correlation, respectively ( Toloraia et al, 2022 ). The Eta-squared function in the “Lsr v0.5.2” R packages was used to calculate the Eta-squared value.…”

Molecular Docking of Zingerone and Gamma-Mangostin to Inhibit MAO-B and Catechol-O-Methyltransferase (COMT) in the Treatment of Parkinson’s Disease

“…Many patients, as the effect of a single dose of levodopa wears off, experience depression, anxiety, sweating, palpitations, increased pain, and non-motor fluctuations (Hansen, et al, 2022;Liu, et al, 2022b;Toloraia, et al, 2022;Lambea-Gil, et al, 2021).…”