Unraveling the mediating role of anxiety and depression: Cultivating mindfulness to improve quality of life in Parkinson's disease patients.

OBJECTIVE

To explore the associations between mindfulness, psychological distress, and health-related quality of life (HRQOL), and examine whether psychological distress mediates the association between mindfulness and HRQOL in individuals with Parkinson's disease (PD).

METHODS

This is a secondary analysis of baseline data from a clinical trial investigating mindfulness-based interventions in patients with mild-to-moderate PD (n = 159). Participants completed validated questionnaires assessing mindfulness, psychological distress (anxiety and depression), disease-specific HRQOL, and assessor-rated motor symptom severity.

RESULTS

The sample consisted of 159 participants, including 83 female (52.2%) with a mean age of 64.8 years (SD = 7.9). Of these, 107 participants (67.3%) were classified at Hoehn and Yahr stage 3. Independent t-tests showed that psychologically distressed individuals had significantly lower mindfulness levels and poorer HRQOL than non-distressed individuals. Multiple linear regression analyses showed that higher mindfulness levels were associated with reduced anxiety and depression and improved HRQOL, particularly in the non-judging and acting with awareness facets. Mediation analyses demonstrated that anxiety and depression fully mediated the relationship between the observing and non-judging facets of mindfulness and HRQOL. In contrast, acting with awareness facet was partially mediated by both anxiety and depression, while describing facet was fully mediated by depression alone.

CONCLUSION

Integrating mindfulness interventions into clinical pathways for neurodegenerative diseases could offer patients with effective tools to improve their quality of life. These interventions, focused on observing, non-judging, and acting with awareness, could enhance psychological care. Notably, for individuals at risk of comorbid depression, the 'describing' facet of mindfulness may play a particularly critical role in mitigating psychological distress.