Risk of Parkinson's disease in people with New Onset Anxiety over 50 years - Incidence and Associated Features.

BACKGROUND:Anxiety has been identified as a prodromal feature of Parkinson's disease (PD). The prospective risk of PD in those newly presenting with anxiety and factors that increase the risk of PD in patients with anxiety have not been investigated. AIM:To investigate the incidence of PD in people with anxiety above the age 50 years and clinical features associated with later diagnosis of PD in people with anxiety. DESIGN AND SETTING:Retrospective cohort study using UK primary care data of people between 2008 and 2018 who had new onset anxiety over the age of 50 years. METHOD:We fitted Weibull survival regression models and estimated hazard ratios (HR) for modelling time-to-PD in those with and without anxiety and when determining the risk of developing PD in those with anxiety. Results were adjusted for sociodemographic and lifestyle factors and relevant physical and mental health conditions. RESULTS:The risk of PD was increased 2-fold compared to the non-anxiety group after adjustment for age, sex, social deprivation, lifestyle factors, severe mental illness, head trauma and dementia HR 2.1 (CI: 1.9-2.4). In those with anxiety, the presence of depression, hypotension, tremor, rigidity, balance impairment, constipation, sleep disturbance, fatigue, and cognitive impairment were associated with an increased risk of developing PD. CONCLUSION:The risk of developing PD was at least doubled in people with anxiety compared to those without. The clinical features of those who developed PD can help identify patients presenting with anxiety who are in the prodromal phase of PD.