Hostname: page-component-745bb68f8f-lrblm Total loading time: 0 Render date: 2025-01-23T08:10:27.659Z Has data issue: false hasContentIssue false
  • English
  • Français

Cognition, coping, and outcome in Parkinson's disease

Published online by Cambridge University Press:  22 May 2012

Catherine S. Hurt ,
Sabine Landau ,
David J. Burn ,
John V. Hindle ,
Mike Samuel ,
Ken Wilson  and
Richard G. Brown
Catherine S. Hurt*
Affiliation:
School of Health Sciences, City University London, London, UK
Sabine Landau
Affiliation:
Department of Biostatistics, Institute of Psychiatry, King's College London, London, UK
David J. Burn
Affiliation:
Clinical Ageing Research Unit, Institute for Ageing and Health, Newcastle University, Newcastle upon Tyne, UK
John V. Hindle
Affiliation:
Department of Care of the Elderly, Betsi Cadwaladr University Health Board, Llandudno Hospital, Llandudno; and School of Medical Sciences, University of Bangor, Bangor, UK
Mike Samuel
Affiliation:
Department of Neurology, King's College Hospital NHS Foundation Trust, King's Health Partners, London; and Department of Neurology, East Kent Hospitals NHS Trust, Ashford, KentUK
Ken Wilson
Affiliation:
Emi Academic Unit, St Catherine's Hospital, University of Liverpool, Wirral, UK
Richard G. Brown
Affiliation:
Department of Psychology, Institute of Psychiatry, King's College London, London, UK
*
Correspondence should be addressed to: Dr. Catherine S. Hurt, Health Services Research, Room 224, College Building, City University London, Northampton Square, London EC1V 0HB, UK. Phone: +44-20-7040-0883; Fax: +44-20-7040-0875. Email: [email protected].
Get access

Abstract

Background: Cognitive impairment and depression are common and disabling non-motor symptoms of Parkinson's disease (PD). Previous studies have shown associations between them but the nature of the relationship remains unclear. In chronic illness, problem- or task-oriented coping strategies are associated with better outcome but often require higher level cognitive functioning. The present study investigated, in a sample of patients with PD, the relationships between cognitive function, choice of coping strategies, and a broad index of outcome including depression, anxiety, and health-related quality of life (QoL). It was hypothesized that the coping strategy used could mediate the association between cognition and outcome.

Methods: 347 participants completed the Coping Inventory for Stressful Situations, the Hospital Anxiety and Depression Scale, the Parkinson's Disease Questionnaire-8, the Unified Parkinson's Disease Rating Scale, and the Addenbrooke's Cognitive Examination–Revised. Structural Equation Modeling was used to test the hypothesized model of cognition, coping, and outcome based on a direct association between cognition and outcome and an indirect association mediated by coping.

Results: Overall, poorer cognition predicted less use of task-oriented coping, which predicted worse outcome (a latent variable comprised of higher depression and anxiety and lower QoL). The analyses suggested a small indirect effect of cognition on outcome mediated by coping.

Conclusions: The findings suggest that patients who fail to employ task-oriented coping strategies may be at greater risk of depression, anxiety, and poor health-related QoL. Even mild to moderate cognitive impairment may contribute to reduced use of task-oriented coping. Suitably adapted cognitive–behavioral approaches may be useful to enable the use of adaptive coping strategies in such patients.

Keywords

copingcognitive impairmentParkinson's diseasedepressionanxiety
Type
Research Article
Information
International Psychogeriatrics , Volume 24 , Issue 10 , October 2012 , pp. 1656 - 1663
Copyright
Copyright © International Psychogeriatric Association 2012

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Aarsland, D., Zaccai, J. and Brayne, C. (2005). A systematic review of prevalence studies of dementia in Parkinson's disease. Movement Disorders, 20, 1255–1263.CrossRefGoogle ScholarPubMed
Arean, P. A. and Cook, B. L. (2002). Psychotherapy and combined psychotherapy/pharmacotherapy for late life depression. Biological Psychiatry, 52, 293–303.CrossRefGoogle ScholarPubMed
Arean, P. A., Perri, M. G., Nezu, A. M., Schein, R. L., Christopher, F. and Joseph, T. X. (1993). Comparative effectiveness of social problem-solving therapy and reminiscence therapy as treatments for depression in older adults. Journal of Consulting and Clinical Psychology, 61, 1003–1010.CrossRefGoogle ScholarPubMed
Baron, R. and Kenny, D. (1986). The moderator-mediator variable distinction in social psychological research: conceptual, strategic and statistical considerations. Journal of Personality and Social Psychology, 51, 1173–1182.CrossRefGoogle ScholarPubMed
Bollen, K. A. (1990). Overall fit in covariance structure model: two types of sample-size effects. Psychological Bulletin, 107, 256–259.CrossRefGoogle Scholar
Brown, R. G. et al. (2011). Depression and anxiety related subtypes in Parkinson's disease. Journal of Neurology, Neurosurgery and Psychiatry, 82, 803–809.CrossRefGoogle ScholarPubMed
Bucks, R. S., Cruise, K. E., Skinner, T. C., Loftus, A. M., Barker, R. A. and Thomas, M. G. (2011). Coping processes and health-related quality of life in Parkinson's disease. International Journal of Geriatric Psychiatry, 26, 247–255.CrossRefGoogle ScholarPubMed
Byrne, B. (2001). Structural Equation Modeling with AMOS: Basic Concepts, Applications and Programming. Mahwah, NJ: Lawrence Erlbaum.Google Scholar
Chaudhuri, K. R., Healy, D. G. and Schapira, A. H. (2006). Non-motor symptoms of Parkinson's disease: diagnosis and management. Lancet Neurology, 5, 235–245.CrossRefGoogle ScholarPubMed
Craigie, M. A. and Nathan, P. (2009). A nonrandomized effectiveness comparison of broad-spectrum group CBT to individual CBT for depressed outpatients in a community mental health setting. Behavior Therapy, 40, 302–314.CrossRefGoogle Scholar
Dobkin, R. D. et al. (2011). Cognitive-behavioral therapy for depression in parkinson's disease: a randomized, controlled trial. American Journal of Psychiatry, 168, 1066–1074.CrossRefGoogle ScholarPubMed
Dobkin, R. D. et al. (2012). Predictors of treatment response to cognitive-behavioral therapy for depression in Parkinson's disease. Journal of Consulting and Clinical Psychology. Epublished ahead of print, doi: 10.1037/a0027695.CrossRefGoogle ScholarPubMed
Endler, N. and Parker, J. (1999). Coping Inventory for Stressful Situations: Manual. Toronto: MHS.Google Scholar
Fahn, S. and Elton, R. L. (1987). Unified Parkinson's disease rating scale. In Fahn, S., Marsden, C. D., Goldstein, M. and Calne, D. (eds.), Recent Development in Parkinson's Disease (pp. 153–163). Florham Park, NJ: Macmillan Healthcare Information.Google Scholar
Felton, B. J. and Revenson, T. A. (1984). Coping with chronic illness: a study of illness controllability and the influence of coping strategies on psychological adjustment. Journal of Consulting and Clinical Psychology, 52, 343–353.CrossRefGoogle ScholarPubMed
Folkman, S. and Lazarus, R. S. (1988). The relationship between coping and emotion: implications for theory and research. Social Science and Medicine, 26, 309–317.CrossRefGoogle ScholarPubMed
Foltynie, T., Brayne, C. E., Robbins, T. W. and Barker, R. A. (2004). The cognitive ability of an incident cohort of Parkinson's patients in the UK: the CamPaIGN study. Brain, 127, 550–560.CrossRefGoogle ScholarPubMed
Goretti, B. et al. (2010). Impact of cognitive impairment on coping strategies in multiple sclerosis. Clinical Neurology and Neurosurgery, 112, 127–130.CrossRefGoogle ScholarPubMed
Hinnell, C., Hurt, C. S., Landau, S., Brown, R. G. and Samuel, M. (2012). Non-motor vs motor symptoms: how much do they matter to health status in Parkinson's disease? Movement Disorders, 27, 236–241.CrossRefGoogle Scholar
Hughes, A. J. et al. (1992). Accuracy of clinical diagnosis of idiopathic Parkinson's disease: a clinico-pathological study of 100 cases. Journal of Neurology, Neurosurgery and Psychiatry, 55, 181–184.CrossRefGoogle ScholarPubMed
Hurt, C. S. et al. (2011). Coping in Parkinson's disease: an examination of the coping inventory for stressful situations. International Journal of Geriatric Psychiatry, 26, 1030–1037.CrossRefGoogle ScholarPubMed
Jenkinson, C., Fitzpatrick, R., Petrone, A., Greenhall, R. and Hyman, N. (1997). The PDQ-8: development and validation of a short-form Parkinson's disease questionnaire. Psychology and Health, 12, 805–814.CrossRefGoogle Scholar
Laidlaw, K. (2001). An empirical review of cognitive therapy for late life depression: does research evidence suggest adaptations are necessary for cognitive therapy with older adults? Clinical Psychology & Psychotherapy, 8, 1–14.CrossRefGoogle Scholar
Mackin, R. S., Arean, P. and Elite-Marcandonatou, A. (2006). Problem solving therapy for the treatment of depression for a patient with Parkinson's disease and mild cognitive impairment: a case study. Neuropsychiatric Disorders and Treatment, 2, 375–379.CrossRefGoogle ScholarPubMed
Mioshi, E., Dawson, K., Mitchell, J., Arnold, R. and Hodges, J. R. (2006). The Addenbrooke's Cognitive Examination Revised (ACE-R): a brief cognitive test battery for dementia screening. International Journal of Geriatric Psychiatry, 21, 1078–1085.CrossRefGoogle ScholarPubMed
Mohlman, J. et al. (2010). A novel approach to treating anxiety and enhancing executive skills in an older adult with Parkinson's disease. Clinical Case Studies, 9, 74–90.CrossRefGoogle Scholar
Mohlman, J., Chazin, D. and Georgescu, B. (2011). Feasibility and acceptance of a nonpharmacological cognitive remediation intervention for patients with Parkinson disease. Journal of Geriatric Psychiatry and Neurology, 24, 91–97.CrossRefGoogle ScholarPubMed
Mondolo, F., Jahanshahi, M., Grana, A., Biasutti, E., Cacciatori, E. and Di Benedetto, P. (2006). The validity of the hospital anxiety and depression scale and the geriatric depression scale in Parkinson's disease. Behavioural Neurology, 17, 109–115.CrossRefGoogle ScholarPubMed
Montel, S., Bonnet, A. M. and Bungener, C. (2009). Quality of life in relation to mood, coping strategies, and dyskinesia in Parkinson's disease. Journal of Geriatric Psychiatry and Neurology, 22, 95–102.CrossRefGoogle ScholarPubMed
Montel, S. and Bungener, C. (2008). To what extent does frontal type executive impairment affect coping strategies in Parkinson's disease? European Journal of Neurology, 15, 1131–1134.CrossRefGoogle ScholarPubMed
ONS (2001). The National Statistics Socio-Economic Classification (NS-SEC). Newport: ONS.Google Scholar
Parkinson's Disease Society (2007). A Professional's Guide to Parkinson's Disease. Available at: http://www.parkinsons.org.uk/pdf/B126_Professionalsguide.pdf.Google Scholar
Raggi, A. et al. (2010). Functioning and disability in Parkinson's disease. Disability and Rehabilitation, 32, S33–S41.CrossRefGoogle ScholarPubMed
Reyes, M. A., Lloret, S. P., Gerscovich, E. R., Martin, M. E., Leiguarda, R. and Merello, M. (2009). Addenbrooke's Cognitive Examination validation in Parkinson's disease. European Journal of Neurology, 16, 142–147.CrossRefGoogle ScholarPubMed
Santangelo, G. et al. (2009). Relationship between depression and cognitive dysfunctions in Parkinson's disease without dementia. Journal of Neurology, 256, 632–638.CrossRefGoogle ScholarPubMed
Zigmond, A. S. and Snaith, R. P. (1983). The Hospital Anxiety and Depression Scale. Acta Psychiatrica Scandinavica, 67, 361–370.CrossRefGoogle ScholarPubMed