New Delhi: Parkinson’s disease (PD) is a global concern with the second rank among most prevalent neurodegenerative ailments. This condition, which primarily affects movement and coordination, is characterised by the progressive degeneration of dopamine-producing neurons in the brain. As a result, individuals with PD experience symptoms such as tremors, stiffness, and balance issues. A recent study predicts that PD will affect 14.2 million people by 2040, primarily due to increased life expectancy. Published in the British Journal of General Practice, the study highlights that individuals aged 50 and above who experience anxiety are at twice the risk of developing PD compared to their calmer counterparts.

In an interaction with News9Live, Dr AK Sahani, Director and Chief of Neurology, Indian Spinal Injuries Centre, New Delhi, decoded the link between anxiety and Parkinson’s disease.

The research also indicates that in people with anxiety, depression, sleep disturbances, fatigue, cognitive impairment, hypotension, tremors, rigidity, balance issues, and constipation are significant risk factors for PD. Anxiety, though one of the most common mood-related nonmotor symptoms of PD, is often overlooked.

A study has underpinned the risk of developing Parkinson disease, at least doubled in people over 50 with anxiety compared with those without. The clinical features of those who developed Parkinson disease can help identify patients presenting with anxiety who are in the prodromal phase of Parkinson disease, according to the study.
The importance of recognising anxiety as a potential early marker for Parkinson’s disease has been aptly emphasised, prompting doctors to monitor patients with chronic anxiety for early signs of it and consider proactive management strategies. As per normal practice, a comprehensive assessment of each patient is emphasised to consider all risk factors and comorbidities, rather than focusing solely on anxiety.

“Anxiety may contribute to the development of PD in people over 50 due to neurodegenerative changes in brain areas due to less dopamine secretion in the brain. Degeneration in these areas could lead to anxiety symptoms before motor symptoms become apparent. Chronic anxiety may lead to persistent neuroinflammation, linked to PD pathogenesis, with inflammatory cytokines damaging dopaminergic neurons and potentially accelerating PD onset. Additionally, anxiety can alter neurotransmitter levels, particularly dopamine, and lead to neurodegeneration in PD. Clinically speaking, it is also evident that not everyone with anxiety will develop Parkinson’s disease. While anxiety is common, the risk of developing PD due to anxiety is influenced by genetic predisposition, environmental factors, and the severity and duration of anxiety,” said Dr Sahani.

Intensity depends on various factors. Anxiety with depression is more likely to develop PD. Chronic and severe anxiety with depression may significantly impact the risk. Early manifestations of anxiety in PD might include generalised anxiety disorder and panic attacks. Controlling anxiety through lifestyle changes, therapy, and medication can potentially reduce the risk of developing the disease. Anxiety can be controlled. But it cannot save a person from PD. Treatment may include Cognitive Behavioral Therapy (CBT), anti-anxiety, anti-depression drugs, and lifestyle modifications. The claim that people with dizziness, shoulder pain, and urinary and erectile problems are less likely to develop PD appears a long drown conclusion. This suggests these symptoms might not be directly related to the neurodegenerative processes involved in PD.

Some symptoms may be result of comorbidities and can lead to different diagnostic pathways, diverting attention from early PD detection. For a neurologist, the study can be useful in recognising anxiety as a potential early marker for PD. The findings encourage us to monitor patients with chronic anxiety for early signs of PD and consider more proactive management strategies. However, it is pertinent to note that these findings with caution. Correlation does not imply causation, and it requires more clinical evidence to understand the underlying mechanisms and to develop targeted interventions.

Recognising anxiety as an early indicator of Parkinson’s disease could transform patient care by enabling earlier diagnosis and intervention. While not all individuals with anxiety will develop PD, heightened awareness and proactive management could mitigate risks and improve patient outcomes. Further research is essential to deepen our understanding of this connection and to refine treatment strategies.