Distinct and Combined Cognitive Profiles associated with Depression and Anxiety in Early Parkinson's Disease

Objective Cognitive impairment is a major non-motor manifestation of Parkinson's disease (PD), and mood disorders, including depression and anxiety, are increasingly recognized as potentially modifiable contributors to cognitive decline. However, studies simultaneously evaluating the individual and combined effects of depression and anxiety on specific cognitive domains in PD remain limited. Methods One hundred forty-nine patients with early-to-mid-stage PD were stratified by depression (BDI ≥ 14) and anxiety (BAI ≥ 8) status. Cognitive performance was evaluated using the Seoul Neuropsychological Screening Battery (SNSB). Group differences were analyzed using ANCOVA, adjusting for education, H-Y stage, and MDS-UPDRS motor scores, followed by Bonferroni correction for multiple testing. Results After adjustment for covariates, depression was associated with impaired verbal recognition memory (p = 0.009), although this did not survive Bonferroni correction. Conversely, anxiety-related deficits immediate visual recall (p = 0.006) and inhibitory executive control (p = 0.016) remained robustly significant even after rigorous correction. Patients with comorbid depression and anxiety exhibited the most pervasive cognitive impairment, including statistically resilient deficits in both visual memory and frontal executive function (all adjusted p < 0.05). Conclusion Depression and anxiety exert distinct yet additive detrimental effects on cognition in early PD. While anxiety and comorbid symptoms show robust associations with visuospatial and executive deficits, the impact of isolated depression appears less statistically stable under conservative thresholds. These findings underscore the importance of early neuropsychiatric screening and targeted intervention, which may be associated with the maintenance of cognitive health in PD.