Anxiety disorders are very commonly encountered when caring for Parkinson’s patients. The authors of this study evaluated the relationship between anxiety as defined by DSM-IV criteria and PD. Risk factors for the development of anxiety in PD were also explored. Twenty-five percent of patients with PD met criteria for diagnosis of an anxiety disorder (Panic disorder, GAD, and social phobia were the most common) and there was an overlap with a diagnosis of depression in fourteen percent of patients. The presence of anxiety was associated with the severity of PD, but not duration of symptoms. In addition, PD patients with postural instability and gait dysfunction were more likely to have anxiety than tremor dominant patients. The presence of motor fluctuations and dyskinesias were associated with anxiety, although levodopa dose was not. Young onset PD patients were more likely to have anxiety than late onset patients. The authors suggest further investigations into the relationships between anxiety and PD.


Movement Disorders 2010 April; 25 (7); e-published ahead of print
http://www3.interscience.wiley.com/journal/12334423 3/abstract

The authors in this study reviewed medical records 109 patients evaluated at the SFVAMC Parkinson’s center (almost all after 1989). The study quantified dyskinesia risks for different Parkinson’s onset ages using a Kaplan-Meier analysis and Cox proportional hazard models. At 5 years of levodopa treatment, the dyskinesia risk for patients with onset age 40-49 was 70%, decreasing to 42% for onset ages 50-59, 33% for onset ages 60-69, and 24% for onset ages 70-79. Pairwise comparisons between the 40-49 age group and the other age groups were statistically significant in time-to-event models. After 5 years of levodopa treatment, dyskinesia risks became uniformly high regardless of age of onset. The authors suggest that dyskinesia risk is more related to age of onset of PD and less related to levodopa usage. Further they suggest that if more than 5 years of levodopa therapy are anticipated, dyskinesia risk has little utility in deciding upon the choice of Parkinson’s therapy.

Movement Disorders. 2010 March; e-published ahead of print
http://www3.interscience.wiley.com/journal/12332764 3/abstract 

Family care research has identified negative outcomes of providing care to a spouse with Parkinson's disease (PD), such as declining physical and mental health. It is important for clinicians to identify "at risk" family caregivers and provide earlier interventions. This study compared the difference in negative aspects of strain and modulators of strain in young and older PD spouse caregivers. Even in early stage disease before significant care is required, young spouses (40-55) were found to be at greater risk for negative consequences of the care situation reporting significantly more strain from lack of personal resources, and lower levels of mutuality and rewards of meaning than older (greater than 70) spouses. As expected, young spouses were more likely to be working, caring for children in the home, and in better physical health than older spouses. Young age was found to be an important risk factor for the morbidity of long term caregiving. Clinicians are well-situated to identify the unique needs of young spouses and intervene early in the caregiving trajectory.

Movement Disorders. 2010; April 30; 25 (6)716-22.