Association between anxiety, depression, and fatigue in elderly patients with Parkinson's disease

Parkinson's disease (PD) is a common neurodegenerative disorder in the elderly population. Non-motor symptoms such as anxiety and depression are often subtle, hindering early detection and intervention, yet they markedly affect quality of life and clinical outcomes.

To investigate the prevalence of anxiety and depression in elderly PD patients, identify associated risk factors, and assess their relationship with fatigue severity.

A cross-sectional analysis was conducted in 123 elderly PD patients treated at The Second Rehabilitation Hospital of Shanghai between January 2023 and December 2024. Demographic and clinical data were obtained using standardized questionnaires. Anxiety, depression, and fatigue were assessed using the Beck Anxiety Inventory (BAI), Geriatric Depression Scale (GDS), and Fatigue Scale-14 (FS-14), respectively. Binary logistic regression identified risk factors for anxiety and depression, whereas Spearman's correlation assessed associations with fatigue.

Anxiety and depression prevalence rates were 64.2% (mean BAI score: 19.59 ± 10.92) and 56.1% (mean GDS score: 12.82 ± 6.37), respectively. The mean FS-14 total score was 9.46 ± 1.89, comprising physical (5.77 ± 1.51) and mental (3.69 ± 1.20) fatigue components. Significant positive correlations were observed between fatigue scores (total, physical, and mental) and both anxiety and depression (all P < 0.05). Univariate analysis revealed statistically significant associations between anxiety/depression and monthly income, disease duration, and disease severity (all P < 0.05). Multivariate logistic regression indicated higher anxiety risk in patients with lower monthly income, prolonged disease duration, advanced disease severity, or multimorbidity. Depression risk was elevated in patients with lower monthly income and severe disease, whereas longer disease duration unexpectedly served as a protective factor.

Elderly PD patients show high rates of anxiety and depression, both of which are significantly correlated with fatigue severity. These findings highlight the importance of psychological monitoring and targeted mental health interventions in PD management among the elderly.