Parkinson’s risk doubles in older adults with anxiety: UK study

Research into prodrome condition could mean earlier diagnosis, treatment

Lindsey Shapiro, PhD avatar

by Lindsey Shapiro, PhD |

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A person holds their body, while biting on their fingernails and with swear pouring off of them.

The risk of developing Parkinson’s disease is double in adults older than 50 with anxiety relative to those without it in a recent U.K. study.

Other Parkinson’s-associated symptoms, such as sleep issues, constipation, and tremors, were also associated with an elevated Parkinson’s risk in people with anxiety.

“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,” Juan Bazo Avarez, PhD, of University College London (UCL) and one of the study’s first authors, said in a press release. The study, “Risk of Parkinson’s disease in people aged ≥50 years with new-onset anxiety: a retrospective cohort study in UK primary care,” was published in the British Journal of General Practice.

Scientists have begun in recent years to more thoroughly understand the Parkinson’s disease prodrome, where nonmotor symptoms like depression, smell loss, and sleep problems emerge sometimes years before motor symptoms enable a diagnosis.

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Anxiety as early symptom of Parkinson’s

Anxiety is also a known feature of the Parkinson’s prodrome, but it hasn’t been as well studied, and whether its presence is associated with an increased risk of developing the neurodegenerative disease hasn’t been established. Studies that have explored this matter haven’t taken into account important variables like lifestyle or socioeconomic factors, said the researchers here who examined primary care clinical data in a large electronic health record database in the U.K. between 2008 and 2018 to analyze the risk of Parkinson’s in people with anxiety while accounting for such variables.

The analysis included 109,435 adults, ages 50-99, who had a record of new-onset anxiety after age 50. Also included were 878,256 age- and sex- matched people without anxiety.

People with anxiety were found to more often have sleep problems, depression, fatigue, and constipation than those without it. Among those with anxiety, 331 people developed Parkinson’s disease during the follow-up period, with a median time to diagnosis after the first anxiety episode of around five years.

The risk of Parkinson’s was more than double in people with anxiety relative to those without it, even after adjusting for age, sex, social factors, lifestyle, severe mental illness, head trauma, and dementia.

People without anxiety survived on average longer without developing Parkinson’s than people with anxiety.

People with anxiety had several other features of the Parkinson’s prodrome associated with an increased risk of Parkinson’s. These included nonmotor symptoms of depression, sleep disturbances, fatigue, cognitive impairment, low blood pressure, and constipation, along with motor symptoms such as tremor, rigidity, and balance problems.

“The results suggest that there is a strong association between anxiety and later diagnosis of [Parkinson’s disease],” the researchers wrote.

Since the analysis relied on electronic health records, it was limited by the information entered into them. Underreporting and under-recording of mental health issues in older people may mean the true predictive role of anxiety wasn’t “fully captured,” said the researchers, who noted the possibility that only the most severe instances of anxiety were captured.

More research is needed to better understand why anxiety increases the risk of Parkinson’s, they said.

“Further research should explore how the early occurrence of anxiety relates to other early symptoms and to the underlying progression of Parkinson’s in its early stages,” said Anette Schrag, MD, PhD, a neurologist, UCL professor, and one of the study’s first authors. “This may lead to better treatment of the condition in its earliest stages.”