Top

BMC Geriatrics

Published in:

Open Access 01-12-2024 | Anxiety | Research

An examination of anxiety and its influence on health-related quality of life in Parkinson’s disease using the geriatric anxiety scale: a cross-sectional study

Authors: Konstantin G. Heimrich, Aline Schönenberg, Sarah Mendorf, Juliane Moussaoui, Tino Prell

Published in: BMC Geriatrics | Issue 1/2024

Abstract

Background

Anxiety is one of the most common but often overlooked mood-related nonmotor symptoms in people with Parkinson’s disease (PD). To improve the well-being of people with PD, it is important to understand the impact of anxiety in PD, especially its association with depressive and motor symptoms and its impact on health-related quality of life (HRQoL).

Methods

91 people with PD were assessed between June 2017 and June 2018. Anxiety was measured using the Geriatric Anxiety Scale (GAS) and its cognitive, somatic, and affective subscales. HRQoL was assessed using the Parkinson’s Disease Questionnaire 39 (PDQ-39). Moreover, sociodemographic information, depressive symptoms, cognition, motor and nonmotor symptoms were assessed. Descriptive statistics, regression analyses, and path analyses were performed to understand predictors of anxiety and its influence on HRQoL.

Results

Of the 91 people with PD, 35 (38.5%) experienced anxiety. Anxiety symptoms in these individuals primarily manifest as somatic sensations. Anxiety, motor, and depressive symptoms are interlinked but contribute individually to HRQoL. Beyond motor symptoms, cognitive and affective aspects of anxiety impact HRQoL. While anxiety and depression overlap, the somatic and cognitive aspects of anxiety play a significant role in determining HRQoL in addition to depressive symptoms.

Conclusion

Our study used the GAS and its three subscales to shed light on the connections between anxiety, depression, and motor impairment in people with PD. Although anxiety is linked to depression and motor symptoms, it independently affects the HRQoL of people with PD. Thus, it is crucial to adopt a comprehensive diagnostic approach that detects and considers the impact of anxiety on HRQoL in PD.

Available only for authorised users

Ou Z, Pan J, Tang S, Duan D, Yu D, Nong H, et al. Global trends in the incidence, prevalence, and years lived with disability of Parkinson’s Disease in 204 Countries/Territories from 1990 to 2019. Front Public Health. 2021;9:776847. https://doi.org/10.3389/fpubh.2021.776847CrossRefPubMedPubMedCentral

Titova N, Qamar MA, Chaudhuri KR. The Nonmotor features of Parkinson’s Disease. Int Rev Neurobiol. 2017;132:33–54. https://doi.org/10.1016/bs.irn.2017.02.016CrossRefPubMed

Balestrino R, Martinez-Martin P. Neuropsychiatric symptoms, behavioural disorders, and quality of life in Parkinson’s disease. J Neurol Sci. 2017;373:173–8. https://doi.org/10.1016/j.jns.2016.12.060CrossRefPubMed

Broen MPG, Narayen NE, Kuijf ML, Dissanayaka NNW, Leentjens AFG. Prevalence of anxiety in Parkinson’s disease: a systematic review and meta-analysis. Mov Disord. 2016;31:1125–33. https://doi.org/10.1002/mds.26643CrossRefPubMed

Kwok JYY, Auyeung M, Chan HYL. Examining factors related to Health-related quality of life in people with Parkinson’s Disease. Rehabil Nurs. 2020;45:122–30. https://doi.org/10.1097/rnj.0000000000000179CrossRefPubMed

Blundell EK, Grover LE, Stott J, Schrag A. The experience of anxiety for people with Parkinson’s disease. Npj Parkinsons Dis. 2023;9:1–9. https://doi.org/10.1038/s41531-023-00512-1CrossRef

Hanna KK, Cronin-Golomb A. Impact of anxiety on quality of life in Parkinson’s disease. Parkinsons Dis. 2012;2012:640707. https://doi.org/10.1155/2012/640707CrossRefPubMed

D’Iorio A, Vitale C, Piscopo F, Baiano C, Falanga AP, Longo K, et al. Impact of anxiety, apathy and reduced functional autonomy on perceived quality of life in Parkinson’s disease. Parkinsonism Relat Disord. 2017;43:114–7. https://doi.org/10.1016/j.parkreldis.2017.08.003CrossRefPubMed

Todorova A, Jenner P, Chaudhuri KR. Non-motor Parkinson’s: integral to motor Parkinson’s, yet often neglected. Pract Neurol. 2014;14:310–22. https://doi.org/10.1136/practneurol-2013-000741CrossRefPubMedPubMedCentral

10.

Dissanayaka NNW, O’Sullivan JD, Pachana NA, Marsh R, Silburn PA, White EX, et al. Disease-specific anxiety symptomatology in Parkinson’s disease. Int Psychogeriatr. 2016;28:1153–63. https://doi.org/10.1017/S1041610215002410CrossRefPubMed

11.

Reynolds CF 3rd, Jeste DV, Sachdev PS, Blazer DG. Mental health care for older adults: recent advances and new directions in clinical practice and research. World Psychiatry. 2022;21:336–63. https://doi.org/10.1002/wps.20996CrossRefPubMedPubMedCentral

12.

Pontone GM, Perepezko KM, Hinkle JT, Gallo JJ, Grill S, Leoutsakos J-M, et al. Anxious fluctuators a subgroup of Parkinson’s disease with high anxiety and problematic on-off fluctuations. Parkinsonism Relat Disord. 2022;105:62–8. https://doi.org/10.1016/j.parkreldis.2022.11.002CrossRefPubMedPubMedCentral

13.

Leentjens AFG, Dujardin K, Marsh L, Martinez-Martin P, Richard IH, Starkstein SE, et al. Anxiety rating scales in Parkinson’s disease: Critique and recommendations. Mov Disord. 2008;23:2015–25. https://doi.org/10.1002/mds.22233CrossRefPubMed

14.

Abou Kassm S, Naja W, Haddad R, Pelissolo A. The relationship between anxiety disorders and Parkinson’s Disease: clinical and therapeutic issues. Curr Psychiatry Rep. 2021;23:20. https://doi.org/10.1007/s11920-021-01229-9CrossRefPubMed

15.

Pontone GM, Dissanayaka N, Apostolova L, Brown RG, Dobkin R, Dujardin K, et al. Report from a multidisciplinary meeting on anxiety as a non-motor manifestation of Parkinson’s disease. NPJ Parkinsons Dis. 2019;5:30. https://doi.org/10.1038/s41531-019-0102-8CrossRefPubMedPubMedCentral

16.

Dissanayaka NNW, Sellbach A, Matheson S, O’Sullivan JD, Silburn PA, Byrne GJ, et al. Anxiety disorders in Parkinson’s disease: prevalence and risk factors. Mov Disord. 2010;25:838–45. https://doi.org/10.1002/mds.22833CrossRefPubMed

17.

Leentjens AFG, Dujardin K, Marsh L, Martinez-Martin P, Richard IH, Starkstein SE. Symptomatology and markers of anxiety disorders in Parkinson’s disease: a cross-sectional study. Mov Disord. 2011;26:484–92. https://doi.org/10.1002/mds.23528CrossRefPubMed

18.

Therrien Z, Hunsley J. Assessment of anxiety in older adults: a systematic review of commonly used measures. Aging Ment Health. 2012;16:1–16. https://doi.org/10.1080/13607863.2011.602960CrossRefPubMed

19.

Rutten S, Ghielen I, Vriend C, Hoogendoorn AW, Berendse HW, Leentjens AFG, et al. Anxiety in Parkinson’s disease: symptom dimensions and overlap with depression and autonomic failure. Parkinsonism Relat Disord. 2015;21:189–93. https://doi.org/10.1016/j.parkreldis.2014.11.019CrossRefPubMed

20.

Landau S, Harris V, Burn DJ, Hindle JV, Hurt CS, Samuel M, et al. Anxiety and anxious-depression in Parkinson’s disease over a 4-year period: a latent transition analysis. Psychol Med. 2016;46:657–67. https://doi.org/10.1017/S0033291715002196CrossRefPubMed

21.

Leentjens AFG, Dujardin K, Marsh L, Richard IH, Starkstein SE, Martinez-Martin P. Anxiety rating scales in Parkinson’s disease: a validation study of the Hamilton anxiety rating scale, the Beck anxiety inventory, and the hospital anxiety and depression scale. Mov Disord. 2011;26:407–15. https://doi.org/10.1002/mds.23184CrossRefPubMed

22.

Leentjens AFG, Dujardin K, Pontone GM, Starkstein SE, Weintraub D, Martinez-Martin P. The Parkinson anxiety scale (PAS): development and validation of a new anxiety scale. Mov Disord. 2014;29:1035–43. https://doi.org/10.1002/mds.25919CrossRefPubMed

23.

Segal DL, Granier KL, Pifer MA, Stone LE. Geriatric anxiety scale. In: Gu D, Dupre ME, editors. Encyclopedia of Gerontology and Population Aging. Cham: Springer International Publishing; 2019. pp. 1–7. https://doi.org/10.1007/978-3-319-69892-2_1103-1CrossRef

24.

Gottschling J, Segal DL, Häusele C, Spinath FM, Stoll G. Assessment of anxiety in older adults: translation and psychometric evaluation of the German version of the geriatric anxiety scale (GAS). J Psychopathol Behav Assess. 2016;38:136–48. https://doi.org/10.1007/s10862-015-9504-zCrossRef

25.

Heimrich KG, Prell T. Short- and long-term effect of Parkinson’s Disease Multimodal Complex Treatment. Brain Sci. 2021;11:1460. https://doi.org/10.3390/brainsci11111460CrossRefPubMedPubMedCentral

26.

Postuma RB, Berg D, Stern M, Poewe W, Olanow CW, Oertel W, et al. MDS clinical diagnostic criteria for Parkinson’s disease. Mov Disord. 2015;30:1591–601. https://doi.org/10.1002/mds.26424CrossRefPubMed

27.

Folstein MF, Folstein SE, McHugh PR. Mini-mental state. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975;12:189–98. https://doi.org/10.1016/0022-3956(75)90026-6CrossRefPubMed

28.

Witt K, Granert O, Daniels C, Volkmann J, Falk D, van Eimeren T, et al. Relation of lead trajectory and electrode position to neuropsychological outcomes of subthalamic neurostimulation in Parkinson’s disease: results from a randomized trial. Brain. 2013;136:2109–19. https://doi.org/10.1093/brain/awt151CrossRefPubMed

29.

Segal DL, June A, Payne M, Coolidge FL, Yochim B. Development and initial validation of a self-report assessment tool for anxiety among older adults: the geriatric anxiety scale. J Anxiety Disord. 2010;24:709–14. https://doi.org/10.1016/j.janxdis.2010.05.002CrossRefPubMed

30.

Jenkinson C, Fitzpatrick R, Peto V, Greenhall R, Hyman N. The Parkinson’s Disease Questionnaire (PDQ-39): development and validation of a Parkinson’s disease summary index score. Age Ageing. 1997;26:353–7. https://doi.org/10.1093/ageing/26.5.353CrossRefPubMed

31.

Goetz CG, Fahn S, Martinez-Martin P, Poewe W, Sampaio C, Stebbins GT, et al. Movement Disorder Society-sponsored revision of the Unified Parkinson’s Disease Rating Scale (MDS-UPDRS): process, format, and clinimetric testing plan. Mov Disord. 2007;22:41–7. https://doi.org/10.1002/mds.21198CrossRefPubMed

32.

Romenets SR, Wolfson C, Galatas C, Pelletier A, Altman R, Wadup L, et al. Validation of the non-motor symptoms questionnaire (NMS-Quest). Parkinsonism Relat Disord. 2012;18:54–8. https://doi.org/10.1016/j.parkreldis.2011.08.013CrossRefPubMed

33.

Beck AT, Steer RA, Brown GK. Manual for the Beck Depression Inventory-II. San Antonio, TX: Psychological Corporation; 1996.

34.

Cohen J. Statistical Power Analysis for the behavioral sciences. 2nd ed. New York: Routledge; 1988. https://doi.org/10.4324/9780203771587CrossRef

35.

Rosseel Y. lavaan: An R Package for Structural Equation Modeling. 2012 2012;48:36%J Journal of Statistical Software. https://doi.org/10.18637/jss.v048.i02

36.

American Psychiatric Association. Diagnostic and statistical manual of mental disorders (5th ed.). 2013.

37.

Dissanayaka NNNW, White E, O’Sullivan JD, Marsh R, Pachana NA, Byrne GJ. The clinical spectrum of anxiety in Parkinson’s disease. Mov Disord. 2014;29:967–75. https://doi.org/10.1002/mds.25937CrossRefPubMed

38.

Pachana NA, Egan SJ, Laidlaw K, Dissanayaka N, Byrne GJ, Brockman S, et al. Clinical issues in the treatment of anxiety and depression in older adults with Parkinson’s disease. Mov Disord. 2013;28:1930–4. https://doi.org/10.1002/mds.25689CrossRefPubMed

39.

Hong C-T, Tan S, Huang T-W. Psychotherapy for the treatment of anxiety and depression in patients with Parkinson Disease: a Meta-analysis of Randomized controlled trials. J Am Med Dir Assoc. 2021;22:2289–e22952. https://doi.org/10.1016/j.jamda.2021.03.031CrossRefPubMed

40.

Kwok JYY, Kwan JCY, Auyeung M, Mok VCT, Lau CKY, Choi KC, et al. Effects of Mindfulness yoga vs stretching and resistance training exercises on anxiety and depression for people with Parkinson Disease: a Randomized Clinical Trial. JAMA Neurol. 2019;76:755–63. https://doi.org/10.1001/jamaneurol.2019.0534CrossRefPubMedPubMedCentral

41.

Ban M, Yue X, Dou P, Zhang P. The effects of yoga on patients with Parkinson’s Disease: a Meta-analysis of Randomized controlled trials. Behav Neurol. 2021;2021:5582488. https://doi.org/10.1155/2021/5582488CrossRefPubMedPubMedCentral

42.

Fan J-Q, Lu W-J, Tan W-Q, Liu X, Wang Y-T, Wang N-B, et al. Effectiveness of acupuncture for anxiety among patients with Parkinson Disease: a Randomized Clinical Trial. JAMA Netw Open. 2022;5:e2232133. https://doi.org/10.1001/jamanetworkopen.2022.32133CrossRefPubMedPubMedCentral

Title: An examination of anxiety and its influence on health-related quality of life in Parkinson’s disease using the geriatric anxiety scale: a cross-sectional study
Authors: Konstantin G. Heimrich
Aline Schönenberg
Sarah Mendorf
Juliane Moussaoui
Tino Prell
Publication date: 01-12-2024
Publisher: BioMed Central
Keywords: Anxiety
Parkinson's Disease
Mood Disorders
Affective Disorder
Published in: BMC Geriatrics / Issue 1/2024
Electronic ISSN: 1471-2318
DOI: https://doi.org/10.1186/s12877-024-04911-8

Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Reserve your place

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin

Prof. Florian Limbourg

Prof. Anoop Chauhan

Developed by: Springer Medicine

Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 1/2024

The relationship and pathways between resting-state EEG, physical function, and cognitive function in older adults

Examining the immunological responses to COVID-19 vaccination in multiple myeloma patients: a systematic review and meta-analysis

Randomized controlled trial of a positive emotion regulation intervention to reduce stress in family caregivers of individuals with Alzheimer’s disease: protocol and design for the LEAF 2.0 study

Low physical activity is a risk factor for sarcopenia: a cross-sectional analysis of two exercise trials on community-dwelling older adults

Implementing advance care planning in palliative and end of life care: a scoping review of community nursing perspectives

Parkinson’s disease with anxiety: clinical characteristics and their correlation with oxidative stress, inflammation, and pathological proteins

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

At a glance: The STEP trials