Freezing of Gait May Be Associated With Anxiety and Depression in Parkinson’s Disease

MIAMI—Freezing of gait in Parkinson's disease may be associated with higher levels of anxiety and depressive symptoms, as well as recurrent falls and lower quality of life, according to research presented at the First Pan American Parkinson's Disease and Movement Disorders Congress.

"Our data suggest that people with Parkinson's disease and freezing of gait have advanced disease, functional limitations, lower balance confidence, and a higher level of anxiety and depressive symptoms, which may negatively impact their quality of life," said Milla Pimenta, a medical student at the Bahiana School of Medicine and Public Health in Brazil, and colleagues. "Future prospective studies should elucidate whether the treatment of anxiety can contribute to reduce the frequency or severity of freezing of gait episodes."

To identify the association between freezing of gait and symptoms of anxiety and depression, the researchers recruited consecutive patients with idiopathic Parkinson's disease and independent walking ability from the Movement Disorders Clinic at the State of Bahia Health Attention Center for the Elderly in Brazil. They excluded patients with other neurologic conditions or comorbidities that affect balance.

The investigators assessed patients' demographics, Parkinson's disease severity and symptoms, medication, disability, freezing, anxiety, depression, self-efficacy, and quality of life.

A total of 78 people with Parkinson's disease (mean age, 70.5; mean Unified Parkinson's Disease Rating Scale motor score, 32; Hoehn and Yahr stages between 1.5 and 4) were included in the study.

Twenty-seven participants (35%) were identified as having freezing of gait (ie, they scored at least 1 point on item 3 of the Freezing of Gait Questionnaire).  

Patients with freezing of gait had higher Hospital Anxiety and Depression Scale scores and lower Activities-Specific Balance Confidence Scale scores, compared with patients without freezing.

Patients with freezing of gait were more likely to have had recurrent falls in the previous year. In addition, patients with freezing had longer median disease duration (nine years versus four years) and received a higher median levodopa equivalent dose (800 mg/day vs 532 mg/day) than patients without freezing. Quality of life, as assessed by the eight-item Parkinson's Disease Questionnaire, was worse in patients with freezing of gait (40.6 vs 25).

—Jake Remaly