Mild cognitive impairment, psychiatric symptoms, and executive functioning in patients with Parkinson's disease

Abstract

Objective Mild cognitive impairment (MCI) and psychiatric symptoms (anxiety, depression, and apathy) are common in Parkinson's disease (PD). While studies have supported the association between psychiatric symptoms and cognitive performance in PD, it is unclear if the magnitude of link between psychiatric symptoms and cognitive health is stronger by MCI status. The purpose of this study was to examine the association between cognitive performance and psychiatric symptoms in PD and whether MCI status moderates this association. Methods/Design Participants (N = 187) completed a comprehensive neuropsychological assessment that included measures of attention, language, executive function (EF), visuospatial ability, episodic memory, and psychiatric symptoms. Participants were classified as PD‐MCI (N = 73) or PD‐normal cognition (NC; N = 114). Linear regression analyses were conducted to examine the association between psychiatric symptoms and cognitive performance and the moderating effect of PD‐MCI status. Results There were no differences in mean psychiatric symptoms between PD‐MCI and PD‐NC. Psychiatric symptoms were predominantly associated with worse EF. The magnitude of the association between anxiety and worse EF was larger in participants with PD‐MCI compared with PD‐NC. A multivariable regression analysis examining the independent contributions of each symptom demonstrated the most robust association between EF and anxiety. Conclusions Symptoms of anxiety, depression, and apathy are associated with worse executive functioning in individuals with PD. PD‐MCI may be important in moderating the association between cognitive performance, specifically anxiety, and EF. Factors that promote cognitive resilience may serve as key therapeutic modalities in managing neuropsychiatric symptoms in PD.

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

“…This finding is consistent with the results of a former study ( 31 ). Numerous researchers have investigated the relationship between anxiety and cognition in PD patients ( 2 , 30 , 32 ).…”

The influence of white matter hyperintensity on cognitive impairment in Parkinson's disease

“…Approximately 30% of PD patients have mild cognitive impairment 15,16 . Moreover, it has been reported that over 80% of PD patients could deteriorate into dementia in the terminal stage of PD, 5,6,17–19 and PD‐MCI patients have an increased risk of dementia 20,21 . Multiple longitudinal studies have shown that PD‐MCI is a prodromal stage of PDD 22–26 .…”

Neuropsychiatric Symptoms in Parkinson’s Disease Patients Are Associated with Reduced Health-Related Quality of Life and Increased Caregiver Burden

“…Mild cognitive impairment in PD is also associated with poorer QoL, more apathy, and depressive symptoms [ 54 ]. Petkus et al revealed that anxiety, depressive symptoms, and apathy are associated with worse executive functioning in PD [ 55 ]. This association is even higher in patients suffering additionally from mild cognitive impairment.…”

“…Even though there is a growing field of studies investigating the neuropathological mechanisms and clinical impact of neuropsychiatric symptoms in PD [ 55 , 56 ], studies analyzing this aspect have still been quite underrepresented compared to research about motor-symptoms in PD [ 35 ]. Focusing more on neuropsychiatric symptoms is important not only for PD, but also in other neurodegenerative diseases, such as Huntington’s Disease (HD) [ 57 ], and even in dystonia [ 26 , 52 ] to implement therapeutical interventions.…”