Cognition, coping, and outcome in Parkinson's disease
Research output: Contribution to journal › Article › peer-review
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In: International Psychogeriatrics, Vol. 24, No. 10, 10.2012, p. 1656-1663.
Research output: Contribution to journal › Article › peer-review
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T1 - Cognition, coping, and outcome in Parkinson's disease
AU - Hurt, Catherine S
AU - Landau, Sabine
AU - Burn, David J
AU - Hindle, John V
AU - Samuel, Mike
AU - Wilson, Ken
AU - Brown, Richard G
AU - PROMS-PD Study Group
PY - 2012/10
Y1 - 2012/10
N2 - 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.
AB - 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.
KW - Adaptation, Psychological
KW - Adult
KW - Aged
KW - Aged, 80 and over
KW - Anxiety
KW - Cognition
KW - Depression
KW - Female
KW - Humans
KW - Male
KW - Middle Aged
KW - Neuropsychological Tests
KW - Parkinson Disease
KW - Psychiatric Status Rating Scales
KW - Quality of Life
KW - Severity of Illness Index
KW - Journal Article
U2 - 10.1017/S1041610212000749
DO - 10.1017/S1041610212000749
M3 - Article
C2 - 22612910
VL - 24
SP - 1656
EP - 1663
JO - International Psychogeriatrics
JF - International Psychogeriatrics
SN - 1041-6102
IS - 10
ER -