Prospective study of phobic anxiety and risk of Parkinson's disease

Mov Disord. 2003 Jun;18(6):646-51. doi: 10.1002/mds.10425.


Anxiety disorders are common in Parkinson's disease (PD). However, the risk of PD among people with anxiety has not been examined in a prospective cohort study. We examined this relation prospectively within the Health Professionals Follow-Up Study, a cohort of US male health professionals. In 1988, anxiety was assessed using the Crown-Crisp phobic anxiety index in 35,815 men without PD, stroke, or cancer at baseline. There were 189 incident cases of PD during 12 years of follow-up. After adjusting for age, smoking, and caffeine intake, the relative risk of PD among men with the highest level of anxiety (Crown-Crisp index scores of 4 and above) was 1.5 (95% CI = 1.0-2.1; P-trend = 0.01) compared to men with the lowest level of anxiety. This positive association persisted after excluding cases of PD with onset in the first 2 years of follow-up. Use of anxiolytic medication was also associated with an elevated risk of PD (RR= 1.6; 95% CI = 0.9-3.1), but adjusting for this potential confounder did not materially affect the association between anxiety and risk of PD. Our results suggest that anxiety is a risk factor for PD. Whether this association is causal or the result of shared underlying biology remains a question.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Aged
  • Female
  • Follow-Up Studies
  • Health Personnel / statistics & numerical data
  • Humans
  • Life Style
  • Male
  • Middle Aged
  • Parkinson Disease / epidemiology*
  • Parkinson Disease / etiology*
  • Phobic Disorders / complications*
  • Prospective Studies
  • Risk Assessment
  • Risk Factors
  • Surveys and Questionnaires
  • United States / epidemiology