Fear of progression in Parkinson's disease: Role of age and occupational status

Background: Parkinson's disease (PD) is a slowly progressing neurodegenerative disorder, so it is likely that people with PD (PwPD) face increasing disability. PwPD thus experience various degrees of fear of progression (FoP), which can become dysfunctional. Objective: This study aims to examine the prevalence of and contributing factors to dysfunctional FoP in PwPD. Methods: The Fear of Progression Questionnaire-Short Form (FoP-Q-SF) was administered along with further questionnaires for non-motor symptoms; PD motor symptoms as reported by the Unified Parkinson's Disease Rating Scale Part III (UPDRS III) were obtained from patient charts. Results: 28% of the 105 PwPD (mean age 66 years, 56% Hoehn & Yahr stage I/II) were categorized as experiencing dysfunctional levels of FoP using the established cut-off score of ≥34. Our analyses revealed that the FoP-Q-SF underestimates the prevalence of dysfunctional FoP in older and non-working PwPD. Using a more appropriate cut-off, 33% of PwPD are classified as having dysfunctional levels of FoP. We found strong correlations of FoP with measures of anxiety, depression and quality of life. Disease duration was secondary to these factors. We found no associations between FoP and motor symptoms. Conclusions: Our findings confirm that dysfunctional FoP significantly impacts the psychological well-being of PwPD, affecting one in three PwPD and contributing to heightened anxiety, depression, and reduced quality of life. Future validation studies are needed to confirm the cut-off value proposed here and to enable a better integration of the concept of FoP into routine care for PwPD.