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.