Measuring anxiety in Lewy Body Disease – Which scale to choose?. (2021)

• Record Type: Journal Article
• Authors: Paniak, Isabel; Lewis, Simon J.G.; Ehgoetz Martens, Kaylena A.
• Is Part Of: Clinical parkinsonism & related disorders. Volume 5(2021)
• Publication Date: 2021
• Subjects: Parkinson's disease -- Periodicals; Movement disorders -- Periodicals; 616.833005
• DOI: 10.1016/j.prdoa.2021.100110
• Languages: English
• ISSNs: 2590-1125

Abstract

Highlights: Parkinson Anxiety Scale is best suited to assess anxiety in synucleinopathies. Anxiety section of the HADS shows strong convergent validity in PD and iRBD. The UPDRS anxiety item did not correlate with any of the other anxiety scales. Abstract: Background: Anxiety is among the most prevalent mood disorders in Lewy Body Disease (LBD) (i.e., Parkinson's disease (PD), Dementia with Lewy bodies DLB), and those at-risk for developing LBD (e.g. isolated REM Sleep Behaviour Disorder (iRBD)). Yet, there is little consensus on which clinical scale best evaluates anxiety across synuclein-based diseases. Objective: This study compared the convergent validity of commonly used anxiety scales across PD, DLB and iRBD patients. Methods: Anxiety was assessed using the Hospital Anxiety and Depression Scale (HADS-A), State-Trait Anxiety Inventory (STAI), MDS-UPDRS Anxiety item, and the Parkinson Anxiety Scale (PAS) in 57 participants (17 PD, 16 DLB, and 23 iRBD). Results: Across all groups, PAS total score was significantly associated with trait anxiety (STAI-Y2), whilst HADS-A was associated with PAS total score in the PD and iRBD group. In DLB patients, HADS-A was weakly associated with PAS total score, and significantly correlated with PAS episodic anxiety. Notably, the anxiety item from the MDS-UPDRS did not correlate with any of the other anxiety outcome measures in any group. Conclusions: PAS and STAI-Y2 are the most suitable scales to assess anxiety in synuclein-based diseases. HADS-A showed strong convergent validity in PD and iRBD, it had weaker convergent validity in DLB. The UPDRS anxiety item did not correlate with any of the other anxiety measures, and thus may not be sensitive at detecting anxiety symptoms. Future work should validate anxiety scales in all Lewy Body Disease groups if they are to be implemented in prospective longitudinal cohorts.