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首页> 外文期刊>Neuropsychology >Worse Cognitive Performance Predicts Increased Anxiety and Depressive Symptoms in Patients With Parkinson's Disease: A Bidirectional Analysis
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Worse Cognitive Performance Predicts Increased Anxiety and Depressive Symptoms in Patients With Parkinson's Disease: A Bidirectional Analysis

机译：更糟糕的认知性能预测帕金森病患者的焦虑和抑郁症状增加：双向分析

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Objective: Symptoms of anxiety, depression commonly co-occur with cognitive decline in patients with Parkinson's disease (PD). The directionality of this association is unclear, however, in that poor cognitive performance may lead to increased symptoms of anxiety and depression or higher anxiety and depressive symptoms may lead to cognitive decline. The purpose of this study was to elucidate the directionality of the association between symptoms of anxiety and depression with cognitive performance in newly diagnosed patients with PD. Method: Longitudinal data from 362 nondemented participants from the Parkinson's Progression Markers Initiative (PPMI) were examined. Participants completed as many as five assessments of anxiety symptoms, depressive symptoms, and cognitive performance over a 4-year period. Bivariate dual change score models were fit to examine the dynamic association between level and change of anxiety and depressive symptoms with level and change in cognitive performance. Results: Across all cognitive domains, worse performance was associated with subsequently higher state anxiety. trait anxiety, and depressive symptoms. The reverse direction was not significant as higher state anxiety, trait anxiety, and depressive symptoms were not associated with subsequent declines in cognitive performance. Conclusions: Poorer cognitive performance, across all cognitive domains, was a risk factor for increased symptoms of anxiety and depression a year later. No support was present for the alternative hypothesis that anxiety and depression are associated with subsequent cognitive decline. Clinical implications include the importance of psychoeducation, as well as assessing and monitoring anxiety and depression in patients with PD with poor cognitive performance.
机译：目的：焦虑症状，抑郁症常常与帕金森病（PD）患者的认知下降共同发生。然而，这种协会的方向性尚不清楚，因为在这种情况下的认知表现可能导致焦虑和抑郁症的症状增加或更高的焦虑和抑郁症状可能导致认知衰退。本研究的目的是阐明新诊断的PD患者焦虑症和抑郁症症状与抑郁症症状之间的方向性。方法：研究了来自帕金森的进展标志物倡议（PPMI）的362名参与者的纵向数据。参与者在4年期间完成了焦虑症状，抑郁症状和认知性能的五个评估。双变量分数模型适合检查水平与焦虑变化与抑郁症状之间的动态关联和认知性能变化。结果：在所有认知域中，性能越来越多地与随后更高的状态焦虑有关。特质焦虑，抑郁症状。相反的方向并不重要，因为更高的州焦虑，特质焦虑和抑郁症状与随后的认知性能下降无关。结论：在所有认知结构域中的认知性能较差，是一年后增加焦虑和抑郁症状的危险因素。替代假设没有任何支持，焦虑和抑郁与随后的认知下降有关。临床意义包括心理教育的重要性，以及评估和监测PD患者的焦虑和抑郁，具有差的认知性能差。

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