AUTHOR=Toloraia Ketevan , Meyer Antonia , Beltrani Selina , Fuhr Peter , Lieb Roselind , Gschwandtner Ute 

TITLE=Anxiety, Depression, and Apathy as Predictors of Cognitive Decline in Patients With Parkinson's Disease—A Three-Year Follow-Up Study

JOURNAL=Frontiers in Neurology

VOLUME=13

YEAR=2022

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2022.792830

DOI=10.3389/fneur.2022.792830

ISSN=1664-2295

ABSTRACT=<sec><title>Objective</title><p>Anxiety, depression, and apathy are the most common neuropsychiatric symptoms in Parkinson's disease (PD) patients. They impair cognitive functioning and have a profound impact on quality of life. This follow-up study aims to investigate the predictive value of anxiety, depression, and apathy on the development of Mild Cognitive Impairment (MCI) in PD patients.</p></sec><sec><title>Methods</title><p>Twenty-nine cognitively unimpaired PD patients (mean age 68.2 SD ± 7.12 years; 13 women) participated in this study. At Baseline (BL) levels of apathy (Apathy Evaluation Scale, AES), depression (Beck Depression Inventory, BDI-II), and anxiety (Beck Anxiety Inventory, BAI), were assessed. Cognitive status was reassessed three years later according to MCI/non-MCI status. For statistics, we used binary logistic regression and receiver operating characteristic curve (ROC) analysis to examine anxiety, apathy, and depression at BL as a predictor of MCI status three years later.</p></sec><sec><title>Results</title><p>Eight of the 29 patients developed MCI. Anxiety level at BL was found to predict MCI status at three-year follow-up (<italic>OR</italic> = 1.20, <italic>CI</italic> = 1.02–1.41, <italic>p</italic> = 0.02), while depression (<italic>OR</italic> = 1.16, <italic>CI</italic> = 0.93–1.47, <italic>p</italic> = 0.20) and apathy (<italic>OR</italic> = 1.06, <italic>CI</italic> = 0.92–1.23, <italic>p</italic> = 0.40) did not predict MCI status. The area under the ROC curve (AUC) of BAI for discriminating PD-non-MCI from PD-MCI was 0.79 (<italic>CI</italic> = 0.61–0.98). The optimal classification threshold yielded a sensitivity of 75.0 % and a specificity of 76.2 %. Neither apathy nor depression at BL discriminated between PD-non-MCI patients from PD-MCI three years later.</p></sec><sec><title>Conclusions</title><p>This study shows an association between anxiety and the development of MCI in PD patients, although the association between apathy, depression, and MCI did not reach a significant level.</p></sec>