Mild cognitive impairment, psychiatric symptoms, and executive functioning in patients with Parkinson's disease
Andrew J Petkus1, J Vincent Filoteo2,3,4, Dawn M Schiehser2,3
1Department of Neurology, University of Southern California, Los Angeles, California.
Objective:
Mild cognitive impairment (MCI) and psychiatric symptoms (anxiety, depression, and apathy) are common in Parkinson's disease (PD). While studies have supported the association between psychiatric symptoms and cognitive performance in PD, it is unclear if the magnitude of link between psychiatric symptoms and cognitive health is stronger by MCI status. The purpose of this study was to examine the association between cognitive performance and psychiatric symptoms in PD and whether MCI status moderates this association.
Methods/Design:
Participants (N = 187) completed a comprehensive neuropsychological assessment that included measures of attention, language, executive function (EF), visuospatial ability, episodic memory, and psychiatric symptoms. Participants were classified as PD-MCI (N = 73) or PD-normal cognition (NC; N = 114). Linear regression analyses were conducted to examine the association between psychiatric symptoms and cognitive performance and the moderating effect of PD-MCI status.
Results:
There were no differences in mean psychiatric symptoms between PD-MCI and PD-NC. Psychiatric symptoms were predominantly associated with worse EF. The magnitude of the association between anxiety and worse EF was larger in participants with PD-MCI compared with PD-NC. A multivariable regression analysis examining the independent contributions of each symptom demonstrated the most robust association between EF and anxiety.
Conclusions:
Symptoms of anxiety, depression, and apathy are associated with worse executive functioning in individuals with PD. PD-MCI may be important in moderating the association between cognitive performance, specifically anxiety, and EF. Factors that promote cognitive resilience may serve as key therapeutic modalities in managing neuropsychiatric symptoms in PD.
Insights
Psychiatric symptoms like anxiety are linked to worse executive function (EF) in Parkinson's disease (PD). This association is stronger in individuals with mild cognitive impairment (MCI), suggesting MCI status matters for cognitive health in PD.
Area of Science:
- Neurology
- Neuropsychology
- Psychiatry
Background:
- Mild cognitive impairment (MCI) and psychiatric symptoms (anxiety, depression, apathy) are prevalent in Parkinson's disease (PD).
- Existing research suggests a link between psychiatric symptoms and cognitive function in PD, but the moderating role of MCI status is not well understood.
Purpose of the Study:
- To investigate the association between cognitive performance and psychiatric symptoms in PD.
- To determine if mild cognitive impairment status moderates the relationship between psychiatric symptoms and cognitive function in PD patients.
Main Methods:
- 187 participants with Parkinson's disease underwent neuropsychological testing and psychiatric symptom assessment.
- Participants were categorized into Parkinson's disease with mild cognitive impairment (PD-MCI) or Parkinson's disease with normal cognition (PD-NC) groups.
- Linear regression analyses examined symptom-cognition associations and the moderating effect of PD-MCI status.
Main Results:
- No significant differences in mean psychiatric symptom levels were found between PD-MCI and PD-NC groups.
- Psychiatric symptoms were primarily associated with poorer executive function (EF).
- The association between anxiety and worse EF was more pronounced in the PD-MCI group compared to the PD-NC group.
Conclusions:
- Anxiety, depression, and apathy correlate with diminished executive function in individuals with PD.
- Mild cognitive impairment status appears to moderate the relationship between anxiety and executive function in Parkinson's disease.
- Enhancing cognitive resilience may be a crucial therapeutic strategy for managing neuropsychiatric symptoms in PD.
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