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Observational Study
Copyright ©The Author(s) 2026. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Psychiatry. Jan 19, 2026; 16(1): 109403
Published online Jan 19, 2026. doi: 10.5498/wjp.v16.i1.109403
Association between anxiety, depression, and fatigue in elderly patients with Parkinson’s disease
Meng-Na Yang, Xiao-Yu Peng, Ye-Ping Chen
Meng-Na Yang, Xiao-Yu Peng, Department of Neurorehabilitation, The Second Rehabilitation Hospital of Shanghai, Shanghai 200431, China
Ye-Ping Chen, Department of Science and Education, The Second Rehabilitation Hospital of Shanghai, Shanghai 200431, China
Author contributions: Yang MN wrote a manuscript, provided administrative support, collected and assembled the data, performed data analysis and interpretation; Yang MN and Peng XY provided the study materials; Yang MN and Chen YP conceptualized and designed the study; all authors participated in manuscript writing and approved the final manuscript.
Supported by Foundation of Shanghai Baoshan Science and Technology Commission, No. 2024-E-66; and Shanghai Nursing Association Scientific Research Project, No. 2024MS-B02.
Institutional review board statement: This study was approved by the Ethic Committee of The Second Rehabilitation Hospital of Shanghai.
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: We have no financial relationships to disclose.
STROBE statement: The authors have read the STROBE Statement – checklist of items, and the manuscript was prepared and revised according to the STROBE Statement – checklist of items.
Data sharing statement: No additional data are available.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ye-Ping Chen, Associate Chief Nurse, Department of Science and Education, The Second Rehabilitation Hospital of Shanghai, No. 8 Lane 860, Changjiang Road, Baoshan District, Shanghai 200431, China. chenyeping1981@163.com
Received: August 15, 2025
Revised: September 26, 2025
Accepted: November 6, 2025
Published online: January 19, 2026
Processing time: 137 Days and 19 Hours
Abstract
BACKGROUND

Parkinson’s disease (PD) is a common neurodegenerative disorder in the elderly population. Non-motor symptoms such as anxiety and depression are often subtle, hindering early detection and intervention, yet they markedly affect quality of life and clinical outcomes.

AIM

To investigate the prevalence of anxiety and depression in elderly PD patients, identify associated risk factors, and assess their relationship with fatigue severity.

METHODS

A cross-sectional analysis was conducted in 123 elderly PD patients treated at The Second Rehabilitation Hospital of Shanghai between January 2023 and December 2024. Demographic and clinical data were obtained using standardized questionnaires. Anxiety, depression, and fatigue were assessed using the Beck Anxiety Inventory (BAI), Geriatric Depression Scale (GDS), and Fatigue Scale-14 (FS-14), respectively. Binary logistic regression identified risk factors for anxiety and depression, whereas Spearman’s correlation assessed associations with fatigue.

RESULTS

Anxiety and depression prevalence rates were 64.2% (mean BAI score: 19.59 ± 10.92) and 56.1% (mean GDS score: 12.82 ± 6.37), respectively. The mean FS-14 total score was 9.46 ± 1.89, comprising physical (5.77 ± 1.51) and mental (3.69 ± 1.20) fatigue components. Significant positive correlations were observed between fatigue scores (total, physical, and mental) and both anxiety and depression (all P < 0.05). Univariate analysis revealed statistically significant associations between anxiety/depression and monthly income, disease duration, and disease severity (all P < 0.05). Multivariate logistic regression indicated higher anxiety risk in patients with lower monthly income, prolonged disease duration, advanced disease severity, or multimorbidity. Depression risk was elevated in patients with lower monthly income and severe disease, whereas longer disease duration unexpectedly served as a protective factor.

CONCLUSION

Elderly PD patients show high rates of anxiety and depression, both of which are significantly correlated with fatigue severity. These findings highlight the importance of psychological monitoring and targeted mental health interventions in PD management among the elderly.

Keywords: Parkinson’s disease; Anxiety; Depression; Elderly; Fatigue severity; Psychological status

Core Tip: Parkinson’s disease (PD) predominantly affects middle-aged and elderly individuals, with an increasing incidence in aging populations. Anxiety and depression are major psychological symptoms that intensify caregiver dependence and impose heavy burdens on patients and families. Fatigue, another disabling but underrecognized non-motor symptom, further compounds disease impact. However, few studies have addressed its relationship with anxiety and depression in PD. This study assessed the prevalence of anxiety and depression, identified related factors, and analyzed their correlation with fatigue severity.