Does MCI Influence the Association Between Anxiety, Cognitive Performance in Parkinson Disease?

Individuals with Parkinson disease (PD) who have symptoms of anxiety, depression, or apathy may experience worse executive functioning, according to a new study. And individuals with PD and anxiety may be especially likely to experience worse executive functioning if they have mild cognitive impairment (MCI).

To analyze the association between cognitive performance and psychiatric symptoms among individuals with PD, the researchers administered a comprehensive neuropsychological assessment—which included measures of attention, language, executive function, visuospatial ability, episodic memory, and psychiatric symptoms—to 187 participants with PD.

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Based on the assessment results, 73 of the participants were classified as having MCI and 114 were classified as having normal cognition.

The researchers then evaluated the association between psychiatric symptoms and cognitive performance and whether PD‐MCI status moderated the association. 

According to the study authors, there were no differences in mean psychiatric symptoms between the two groups. However, they did find that psychiatric symptoms were predominantly associated with worse executive function.

The magnitude of the association between anxiety and worse executive function was more profound among those with MCI than among those with normal cognition. And by assessing the independent contributions of each symptom, it was determined that executive function and anxiety had the strongest association.

“Symptoms of anxiety, depression, and apathy are associated with worse executive functioning in individuals with PD,” the researchers concluded. “PD‐MCI may be important in moderating the association between cognitive performance, specifically anxiety, and executive function.  Factors that promote cognitive resilience may serve as key therapeutic modalities in managing neuropsychiatric symptoms in PD.”

—Colleen Murphy

Reference:

Petkus AJ, Filoteo JV, Schiehser DM, et al. Mild cognitive impairment, psychiatric symptoms, and executive functioning in patients with Parkinson's disease [published online January 1, 2020]. Int J Geriatr Psychiatry. https://doi.org/10.1002/gps.5255.