New Delhi: People aged 50 years and above who experience anxiety should not ignore it as they may face twice the risk of developing Parkinson’s disease compared to those in the same age group who are calm and content, reveals a recent study published in the British Journal of General Practice.Parkinson’s disease (PD) is the second most common neurodegenerative condition worldwide. It is estimated that it will affect 14.2 million people by 2040, mostly due to an increase in life expectancy.In people with anxiety, the study confirmed that depression, sleep disturbance, fatigue, cognitive impairment, hypotension, tremor, rigidity, balance impairment, and constipation are risk factors for PD.Neurologists in Delhi emphasise that this finding can assist them in the early diagnosis and treatment of Parkinson’s disease. Nevertheless, it is crucial to recognise that anxiety, although a potential early symptom, is only one aspect of the multifaceted nature of Parkinson’s disease. While this study sheds light on the connection between anxiety and Parkinson’s, further research is necessary to fully comprehend the complexities of this neurodegenerative disorder.Dr Jaideep Bansal, senior director and head of neurology at Fortis Hospital, Shalimar Bagh, said, “This study prompts healthcare professionals to give more consideration to anxiety symptoms in elderly patients and incorporate them into a comprehensive diagnostic process.” “By recognising and addressing anxiety in a timely manner,” Dr Bansal suggests, “we can enhance the overall well-being of people at risk.”Research shows that anxiety can appear prior to motor symptoms and that individuals with PD generally experience higher levels of anxiety. “One theory suggests that PD may influence the brain’s fear circuitry and may be linked to cognitive changes that happen before other symptoms become apparent,” said Dr (Col) Joy Dev Mukherji, vice chairman & head of neurology, Max Super Speciality Hospital, Saket.Dr PN Renjen, senior neurology consultant at Indraprastha Apollo Hospitals, stated that chronic anxiety can lead to elevated levels of stress hormones, particularly cortisol. The increase in cortisol can damage dopamine-producing neurons in the brain, which is a distinctive feature of Parkinson’s disease. “This damage can disrupt the normal functioning of the brain’s motor control systems, leading to the characteristic symptoms of Parkinson’s, such as tremors, rigidity, and bradykinesia,” he said. Furthermore, anxiety can trigger inflammation, oxidative stress, and mitochondrial dysfunction within the brain. These processes collectively contribute to the neurodegenerative progression observed in Parkinson’s disease.“Some people may experience persistent and unexplained feelings of worry and unease, indicative of a generalised anxiety disorder. Others might encounter sudden episodes of intense fear accompanied by physical symptoms such as a rapid heartbeat and sweating, which are characteristic of panic attacks. Additionally, social situations may trigger heightened self-consciousness and discomfort, leading to social anxiety. These manifestations of anxiety in PD often arise without a clear external cause and tend to persist over an extended period,” said Dr Biplab Das, director and senior consultant, neurology, Narayana Hospital, Gurgaon.Anxiety is a common experience that everyone faces, but when it becomes persistent, uncontrollable, and reaches a pathological level, it can be a predisposing factor for certain conditions, said Prof Manjari Tripathi, head of neurology department of AIIMS. She added that it is important to note that “not all anxious patients will have Parkinson’s disease”.Fortunately, anxiety can be managed through both pharmacological and non-pharmacological approaches. “Adjusting one’s lifestyle, exercise, yoga, seeking therapy, and taking prescribed medication may help lower the chances of developing PD.
