Author: Altay Shaw
Editor: Nirvan Marathe
A recent study, led by UCL Queen Square of Neurology, has shown the risk of developing Parkinson’s is at least twice as high in people with anxiety compared to those without.
Parkinson’s disease (PD) is one of the most common neurodegenerative conditions worldwide. Studies estimate more than 6 million individuals currently suffer from PD with this incidence only expected to increase to more than 12 million by 2040. With an average onset in the sixth decade of life, the disease is pathologically characterised by loss of substantia nigra, the region of the brain critical for the production of dopamine, due to the build up of alpha-synuclein, resulting in impaired movement, cognitive executive functions and speech.
Whilst previously, the presence of anxiety was known to be an early symptom of PD, the risk for those in the fifth decade and onwards was unknown. While studies had reviewed the incidence rates and comorbidities associated with PD, previous studies had considered the impact of lifestyle or socioeconomic background of patients with PD when drawing their conclusions.
This research, led by Professor Anette Schrag and her team, used data from GPs over a decade period between 2008 and 2018, assessing over 100,000 patients who developed anxiety after the age of 50 and compared them to 878,256 matched controls who did not.
During the course of the study, the team tracked known PD features. These included sleep apnoea, depression and unintentional cerebellar signs. These were also assessed alongside the presence of Parkinson’s features – involuntary tremor and impaired balance – from the point of their anxiety diagnosis up until one year before the date of a Parkinson’s diagnosis, aiming to identify the risk of developing the condition. The results showed the risk increased two-fold in those with anxiety, compared to a control cohort.
In a UCL press release, co-lead author, Dr Juan Bazo Alvarez (UCL Epidemiology & Health), said: “Anxiety is known to be a feature of the early stages of Parkinson’s disease, but prior to our study, the prospective risk of Parkinson’s in those over the age of 50 with new-onset anxiety was unknown. By understanding that [anxiety] and the mentioned features are linked to a higher risk of developing Parkinson’s disease over the age of 50, we hope that we may be able to detect the condition earlier and help patients get the treatment they need.”
Whilst the study considered a variety of factors that could contribute to the cases seen, it was hampered by the limited amount of detail which was entered into the patient’s healthcare records. Most primary care staff tend to avoid the use of potentially stigmatising labels, especially as elderly patients tend not to bring up non-physiological symptoms. In addition, portrayals of mental illness within the media prevent help-seeking behaviours in patients, affecting the ability to report on the true scale of the issues and, the ability to recover from such conditions.
Future research should build off of Professor Schrag’s work and review the impact of severity of anxiety on diagnosis with regards to their Parkinson’s disease activity.
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