The Effect Of Anxiety, Depression And Cognitive Function On Motor Function In Patients With Parkinson’s Disease

Objectives To explore the effect of anxiety, depression and cognitive impairment on motor function in patients with Parkinson’s disease(PD).Methods A Case-control study was adopted. 103 PD patients treated in The First Hospital of Hebei Medical University from September 2014 to September 2015 were enroll in this study, and 37 Patients were with mild motor dysfunction, when 66 were with serious motor dysfunction. Basic information such as sex, age, duration, education was collected. Modified Hoehn-Yahr stage was used to evaluate the severity of disease. The third part of Unified Parkinson’s Disease Rating Scale(UPDRSⅢ) was used to evaluate the motor function. The Mini-Mental State Examination(MMSE) and the Montreal Cognitive Assessment(Mo CA) was used to evaluate the cognitive function. The Hamilton Anxiety Scale 14-item version(HAMA14) and Hamilton Depression Scale 24- item version(HAMD24) was used to evaluate the anxiety and depression of patients. Patients were divided into mild motor dysfunction and serious motor dysfunction by UDPRS Ⅲ scores; divided into anxiety group and non-anxiety group by HAMA14 scores; into depression group and nondepression group by HAMD24 scores; into normal cognitive group(PD-NC), mild cognitive impairment group(PD-MCI) and dementia group(PDD) by Mo CA and MMSE scores, chief complaint of cognitive impairment and daily life ability. SPSS 21.0 was used to analysis the data. To find the factors with significant difference in each group. Univariate and multiple logistic regression analysis was used to find the effect factors and independent risk factors of motor function.Results 1 Among 103 patients, 37(35.92%) were with mild motor dysfunction and 66(64.08%)were with serious motor dysfunction. The serious motor dysfunction group were significantly higher in duration, Hoehn-Yahr stage, HAMA14, HAMD24 than mild motor dysfunction group, and significantly lower in MMSE and Mo CA than mild motor dysfunction group.(P<0.05) 2 Among 103 patients, 47(45.63%) were in anxiety. The UPDRSⅢ and HAMD24 scores in patients with anxiety were significantly higher than those in patients without anxiety, and Mo CA scores in patients with anxiety were significantly lower than those in patients without anxiety.(P<0.05). 3 Among 103 patients, 34(33.01%) were in depression. The UPDRSⅢ, HAMA14 scores in patients with depression were significantly higher than those in patients without depression, and Mo C A scores in patients with depression were significantly lower than those in patients without depression.(P<0.05). 4 Among 103 patients, 25(24.27%) were with normal cognitive function, 44(42.72%) were PD-MCI, 34(33.01%) were PDD. The significantly higher age, duration, UPDRSⅢ scores, Hoehn-Yahr stage, HAMA14 scores and HAMD24 scores were found in patients with more serious cognitive impairment groups( P<0.05).The education was in an opposite result. 5 The Univariate logistic regression analysis showed that the duration(OR=7.500, OR95%CI=2.826-19.657, P=0.000), anxiety(OR=2.836, OR95%CI=1.206-6.672, P=0.017) and PDD(OR=7.382, OR95%CI=2.148-25.373, P=0.002) were the effect f actors of exacerbation of motor dyskinesia. The mult iple logistic regression analysi s showed that the the duration(OR=7.258, OR95%CI=2.532-20.728, P=0.000), anxie ty(OR=3.462, OR95%C I=1.269-9.441, P=0.015) and PDD(OR=4.910, OR95%CI=1.2 55-19.215, P=0.022) were the independent risk factors of exacerbation of motor dy skinesia.Conclusions 1 The motor dyskinesia was more serious in PD patients with anxiety, depression and cognitive impairment than that in patients without anxiety, depression and cognitive impairment. 2 Duration, anxiety, depression and PDD were the effect factors of exacerbation of motor dyskinesia. 3 Duration, anxiety and PDD in PD were the independent risk factors of exacerbation of motor dyskinesia.