Anxiety and Depression Are Better Correlates of Parkinson’s Disease Quality of Life Than Apathy

Jones, Jacob D.; Butterfield, London C.; Song, Woo‐Jin; Lafo, Jacob; Mangal, Paul; Okun, Michael S.; Bowers, Dawn

doi:10.1176/appi.neuropsych.13120380

Cited by 42 publications

(33 citation statements)

References 38 publications

(42 reference statements)

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“…This finding is consistent with previous studies showing apathy to have only a minimal influence on QoL, independent of depression (Jones et al, 2014; Leroi et al, 2011). It is possible that apathy may be more detrimental to QoL among caregivers, rather than patients.…”

Section: Discussionsupporting

confidence: 93%

“…Our main finding suggests that QoL is largely related to depressive symptoms among PD patients, regardless of whether individuals with PD experience clinical levels of depression. This finding is consistent with past studies of motor and nonmotor predictors of QoL in PD (Antonini et al, 2012; Kuopio et al, 2000; Karlsen et al, 1999; Jones et al, 2014). In addition to depression, QoL had a smaller relationship to motor symptoms, gender, and age.…”

Section: Discussionsupporting

confidence: 93%

“…Based on past observations of QoL being primarily related to depression, it was predicted that the trajectory of QoL would show the strongest relationship to depressive symptoms (Karlsen et al, 1999; Kuopio et al, 2000; Jones et al, 2014). …”

mentioning

confidence: 99%

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Latent growth-curve analysis reveals that worsening Parkinson’s disease quality of life is driven by depression.

Jones¹,

Marsiske²,

Okun³

et al. 2015

Neuropsychology

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Objective Parkinson’s disease (PD) is a neurodegenerative disorder resulting in a wide variety of symptoms. The current study examined the influence of apathy, depression and motor symptoms on quality of life (QoL) in PD patients. Information was drawn from an 18-month period. Method Participants (N = 397) were assessed for apathy (Apathy Scale; Starkstein et al., 1992), depression (Beck Depression Inventory-II; Beck, Steer, Ball & Ranieri, 1996), motor severity (Unified Parkinson’s Disease Rating Scale, Part III; UPDRS; Fahn, Elton & Committee, 1987), and QoL (Parkinson’s Disease Questionnaire-39; Jenkinson, Fitzpatrick, Peto, Greenhall, & Hyman,1997) at 3 time points: an initial clinical evaluation (baseline), a 6-month follow-up, and an 18-month follow-up. Latent growth-curve models were used to determine the influence of apathy, depression, and motor symptoms on QoL trajectories. Results Greater difficulties with QoL at baseline showed the strongest relationship to more severe depression symptoms, followed by more severe motor symptoms, younger age, and less education (all p values < .001). Worsening of QoL over the 18-month period was only predicted by a worsening of depression (p = .003). The relationship between QoL and depression symptoms remained significant in a subsample of nondepressed PD patients. Conclusion Overall, findings from the current study suggest that self-reported QoL among PD patients is primarily related to depression. Future efforts to improving clinical care of PD patients may benefit by focusing on improving psychosocial adjustment or treatments targeting depression.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 93%

See 1 more Smart Citation

Latent growth-curve analysis reveals that worsening Parkinson’s disease quality of life is driven by depression.

Jones¹,

Marsiske²,

Okun³

et al. 2015

Neuropsychology

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“…Identifying mood symptoms among individuals with cognitive impairment is important for at least two reasons. First, self-reported quality of life has a stronger relationship with mood symptoms (particularly depression) than cognitive symptoms {9, 10}. Secondly, due to the relationship between mood symptoms and cognition, interventions targeting mood symptoms may have the potential to delay the progression of further cognitive impairment {2, 11}.…”

Section: Discussionmentioning

confidence: 99%

“…In normal elderly, not only is depression linked to MCI status, but also apathy and anxiety {9}. Identification of mood symptoms in cognitively impaired individuals is important because mood symptoms are strong predictors of quality of life that may be responsive to interventions {9,10}. Furthermore, due to the negative influence of mood symptoms on cognition, treatments targeting depression, apathy and anxiety may lead to better cognitive functioning {11,12}.…”

Section: Introductionmentioning

confidence: 99%

Mood Differences Among Parkinson’s Disease Patients With Mild Cognitive Impairment

Jones

Mangal

Lafo

et al. 2016

JNP

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Objective Studies with healthy elderly adults suggest apathy, depression and anxiety are more common among individuals with mild cognitive impairment (MCI). We examined differences in mood/amotivational symptoms among Parkinson’s patients with and without MCI. Methods Parkinson patients (N=214) underwent neurocognitive evaluations including assessment of apathy (Apathy Scale; AS), depression (Beck Depression Inventory-II; BDI-II) and trait anxiety (State-Trait Anxiety Inventory-Trait scale; STAI-T). Results Trait anxiety and depression were more severe in PDs with MCI. Delineation of MCI into amnestic vs non-amnestic subtypes revealed greater depression, apathy and anxiety among amnestic MCI relative to cognitively-intact PD patients. Conclusion Parkinson patients with MCI report greater mood symptoms compared to Parkinson patients who are cognitively intact.

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Predictors of health-related quality of life in Parkinson’s disease: the impact of overlap between health-related quality of life and clinical measures

et al. 2022

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Purpose This study aimed to determine predictors of health-related quality of life (HRQoL) in Parkinson's disease (PD) and to explore their predictive value before and after controlling overlapping items between HRQoL and clinical variables. Methods One hundred and eight PD patients underwent motor, anxiety, depression, apathy, fatigue, and neurocognition assessment. HRQoL was assessed by the Parkinson’s Disease Questionnaire-39 (PDQ-39). In order to determine predictors of HRQoL in PD, stepwise multiple regression analyses were performed in two ways: before and after removing the emotional well-being dimension from PDQ-39 to control the overlap between depression and anxiety, and HRQoL. Results HRQoL total index was predicted by anxiety, fatigue, motor symptoms, and depression, explaining 26.9%, 7.2%, 2.8%, and 1.9% of the variance. However, after removing overlapping items, HRQoL total index was predicted by fatigue (16.5%), anxiety (6.1%), motor symptoms (3.9%), and neurocognition (2.5%), but not depression. Regarding HRQoL dimensions, mobility and activities of daily living were predicted by fatigue (19.7% and 5%) and UPDRS-III (4% and 10.2%); emotional well-being by fatigue (7.9%); social support by anxiety (12.2%) and UPDRS-III (8.6%); communication by neurocognition (5.3%) and UPDRS-III (3.4%); cognition by anxiety (10.6%) and bodily discomfort by anxiety (23%) and fatigue (4.1%). Conclusion These findings showed the importance of identifying and controlling overlapping items of HRQoL and clinical measures to perform an accurate interpretation. HRQoL dimensions showed different predictors before and after controlling the overlap. Based on these results fatigue, anxiety, motor symptoms, and neurocognition, but not depression are the main predictors of HRQoL in PD patients.

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Anxiety and Depression Are Better Correlates of Parkinson’s Disease Quality of Life Than Apathy

Cited by 42 publications

References 38 publications

Latent growth-curve analysis reveals that worsening Parkinson’s disease quality of life is driven by depression.

Latent growth-curve analysis reveals that worsening Parkinson’s disease quality of life is driven by depression.

Mood Differences Among Parkinson’s Disease Patients With Mild Cognitive Impairment

Predictors of health-related quality of life in Parkinson’s disease: the impact of overlap between health-related quality of life and clinical measures

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