Clinical management

Increased risk of developing Parkinson’s Disease in people with anxiety

• A retrospective cohort study in the UK used primary care data from 2008-2018 to investigate the incidence of Parkinson’s disease (PD) in people with anxiety aged ≥50 years. Clinical features associated with a later diagnosis of PD in people with anxiety were also investigated.

• The risk of PD increased two-fold compared with the non-anxiety group after adjustment for age, sex, social deprivation, lifestyle factors, severe mental illness, head trauma, and dementia (HR 2.1, 95% confidence interval = 1.9 to 2.4).

• In those with anxiety, co-morbid depression, hypotension, tremor, rigidity, balance impairment, constipation, sleep disturbance, fatigue, and cognitive impairment were associated with an increased risk of developing PD.

WiseGP Actions

1. In people aged ≥50 years presenting with anxiety, tremor is a common associated physical symptom. Before accounting a tremor to anxiety, consider excluding other potential symptoms of PD (eg, rigidity, balance impairment, hypotension).

2. Consider PD in people aged ≥50 years with a tremor that persists following treatment for anxiety.

Read more about the research informing this GEM: https://bjgp.org/content/74/744/e482