Parkinson’s disease: Anxiety may increase risk for people over age 50

The researchers reported that people who were diagnosed with anxiety after the age of 50 were twice as likely to develop Parkinson’s as those without anxiety.

The scientists noted that the risk factors for Parkinson’s included:

The results were adjusted for age, gender, social deprivation, lifestyle factors, severe mental illness, head trauma, and dementia.

These conditions can affect the likelihood of developing Parkinson’s.

“The study provides compelling evidence linking anxiety to an increased risk of developing Parkinson’s disease (PD) in individuals over 50,” said Dr. Daniel Truong, a neurologist and medical director of the Truong Neuroscience Institute at MemorialCare Orange Coast Medical Center in California and editor-in-chief of the Journal of Clinical Parkinsonism and Related Disorders.

“The findings suggest that [new onset] anxiety may be a prodromal symptom of PD, highlighting the importance of early detection and intervention,” Truong, who was not involved in the research, told Medical News Today.

Experts say primary doctors can play a role in early diagnosis of PD by paying attention to people over 50 who are developing anxiety-related conditions.

“Most often, people are reporting to their primary doctors or psychiatrists for treatment and management of anxiety,” said Dr. Shae Datta, the co-director of the Concussion Center, NYU Langone, and the Division Director of the Concussion Center, Long Island, in New York.

“Perhaps they can be closely watched and referred earlier to a neurologist for diagnosis of Parkinson’s. Concurrently, screening & treating anxiety in these presenting patients could help their quality of life and mood,” Datta, who was not involved in the research, told Medical News Today.

Not everyone agrees that anxiety can be utilized as a factor in Parkinson’s disease.

“I would never use anxiety (or depression or sleep disorders) as a diagnostic criterion for Parkinson’s,” said Dr. Clifford Segil, a neurologist at Providence Saint John’s Health Center in California. “Parkinson’s is not a mood disorder and has an entirely different biological reason than anxiety or depression.”

“Some people may become anxious because of a fear of the diagnosis,” Segil, who was not involved in the research, told Medical News Today. “Many people worry about how the diagnosis will affect their lives – so it can cause anxiety at times. Many people worry because they think Parkinson’s is a death sentence – but it is not. Anxiety, at times, might be a by-product of the diagnosis but is not a precursor.”

“Using the information that anxiety can be an early indicator of Parkinson’s disease (PD) can greatly enhance patient care through early detection, proactive monitoring, and comprehensive management,” Truong said.

He listed how this information can be utilized to help patients:

Early Detection and Diagnosis:

Regular screening for anxiety in patients over 50, especially those with new-onset anxiety, can help identify individuals at higher risk for Parkinson’s​. Implementing questionnaires and assessments for anxiety during routine check-ups for older adults can ensure early recognition of anxiety or other potential prodromal Parkinson’s symptoms.

Monitoring for Other Prodromal Symptoms:

Patients identified with anxiety should be monitored for other prodromal symptoms of Parkinson’s, such as sleep disturbances, constipation, depression, and cognitive impairment​.

This comprehensive monitoring approach can facilitate earlier diagnosis of Parkinson’s disease before significant motor symptoms appear, allowing for earlier intervention and management.

Proactive Management Strategies:

Refer patients with persistent or severe anxiety to a neurologist for a thorough evaluation, including neuroimaging and other diagnostic tests to detect early signs of Parkinson’s. Early consultation with specialists can lead to more accurate diagnoses and tailored treatment plans.

Patient Education and Counseling:

Educate patients and their families about the potential link between anxiety and Parkinson’s to raise awareness and encourage early medical consultation for new or worsening symptoms​. Counseling can help patients manage anxiety and stress, which may mitigate some neurodegenerative processes.

Personalized Treatment Plans:

Develop personalized treatment plans that address both the psychological and neurological aspects of care. This can include a combination of pharmacological treatments, cognitive-behavioral therapy (CBT), and lifestyle modifications to manage anxiety and other prodromal symptoms​.

“An integrated care team involving primary care physicians, neurologists, psychiatrists, and psychologists can provide comprehensive support to the patient,” Truong noted. “Schedule regular follow-ups to monitor the progression of symptoms and adjust treatment plans as necessary. This ongoing care can help manage symptoms more effectively and improve the quality of life for patients​. Use follow-up visits to reassess both motor and non-motor symptoms, ensuring any new developments are promptly addressed.”

The researchers suggested that future studies should look at why people over 50 with new-onset anxiety are more at risk of developing Parkinson’s as well as if the severity of anxiety affects the risk.