Risk of Parkinson's disease following anxiety disorders: A nationwide population-based cohort study
Journal
European Journal of Neurology
Journal Volume
22
Journal Issue
9
Pages
1280-1287
Date Issued
2015
Author(s)
Abstract
Background and purpose: Anxiety is potentially a pre-motor symptom of Parkinson's disease (PD). Our aim was to investigate the association between anxiety and subsequent PD risk in a population-based sample. Methods: A total of 174 776 participants, who were free of prior PD, dementia and stroke, were enrolled from Taiwan National Health Insurance Research Database between 1 January 2005 and 31 December 2005. The association between anxiety at the beginning of the study and the incidence of PD was examined using a Cox regression model. Information regarding comorbidities, especially depression, and concomitant medication use was adjusted in the proportional hazards models. Results: Over an average follow-up of 5.5 years, 2258 incident PD cases were diagnosed. After adjusting for age, sex, comorbidities and concomitant medication use, patients with anxiety were more likely to develop PD than subjects without anxiety [adjusted hazard ratio (HR) 1.38; 95% confidence interval (CI) 1.26-1.51]. Anxiety severity was dose-dependently associated with increased likelihood of PD: crude HR 1.27 (95% CI 1.11-1.44) for mild anxiety, 1.35 (95% CI 1.19-1.53) for moderate anxiety and 2.36 (95% CI 2.13-2.62) for severe anxiety (P < 0.0001). Results were similar after adjustment for age, sex, comorbid depression and other PD risk factors, and in the sensitivity analyses excluding participants with comorbid depression or with a PD diagnosis <3 years after anxiety diagnosis, and controlling for Charlson's scores. Conclusions: The likelihood of developing PD was greater amongst patients with anxiety than patients without anxiety, and the severity of anxiety correlated with risk of PD. ? 2015 EAN.
SDGs
Other Subjects
anxiolytic agent; adult; aged; anxiety disorder; Article; Charlson Comorbidity Index; cohort analysis; comorbidity; controlled study; data base; depression; disease association; disease severity; female; follow up; human; incidence; insomnia; major clinical study; male; middle aged; Parkinson disease; priority journal; risk factor; Taiwan; Anxiety Disorders; Parkinson disease; severity of illness index; Aged; Anxiety Disorders; Female; Follow-Up Studies; Humans; Male; Middle Aged; Parkinson Disease; Risk Factors; Severity of Illness Index; Taiwan
Publisher
Blackwell Publishing Ltd
Type
journal article