ArticleFrontiers in psychiatry2026
Depression and cognition mediated rapid eye movement sleep behavior disorder to improve the activities of daily living in Parkinson's disease patients.
Article in Frontiers in psychiatry, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction: Rapid eye movement sleep behavior disorder (RBD) aggravates cognitive impairment and depression in patients with Parkinson's disease (PD) and significantly compromises their activities of daily living (ADL). This study aimed to explore the potential mediation roles of depression and cognitive impairment between RBD and ADL in PD patients. Methods: Data from the Parkinson's Progression Markers Initiative (PPMI) database comprised 337 patients. RBD, ADL, depression, and cognitive function were assessed with validated rating scales. Bayesian dynamic mediation analysis was employed to evaluate the separate mediating effects of depression and cognition in mediating RBD and ADL with the time variable (9 times) standardized to the interval [0, 1] via min-max normalization. Multiple time-varying causal mediation analysis was used to assess the role of depression and cognition together in mediating RBD and ADL. Results: At the second follow-up (0.25), the fourth follow-up (0.50), and the sixth follow-up (0.75), the Bayesian dynamic indirect mediating effect of depression between RBD and ADL were 0.058 (95% Discussion: This study demonstrates that depression and cognition can work independently and together, and that reducing depressive symptoms or improving cognition can mediate the reduction of RBD to improve the ADL of PD patients. Notably, this mediating effect gradually intensifies as the duration of the disease progresses. These findings highlight that for PD patients, preventing emotional depression and cognitive decline in the early stage of the disease may reduce the damage caused by RBD.
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