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Exploring fatigue in mild Parkinson's disease across symptoms - A cross-sectional study with implications for walking ability

Lindholm, Beata LU orcid ; Ekman, Urban ; Szymanska, Anna LU and Franzén, Erika (2026) In Parkinsonism & Related Disorders 148.
Abstract

OBJECTIVE: Fatigue is a common and debilitating non-motor symptom of Parkinson's disease (PD), arising from a complex interplaying underlying factors. While mental health and sleep are well-established evidence regarding motor symptoms, balance, gait, and cognition remain inconsistent. By explicitly examining multiple symptom domains within the same cohort, we aimed to identify which factors are most strongly associated with fatigue in PD.

METHODS: This cross-sectional study included 64 individuals with PD. Fatigue was measured using the Functional Assessment of Chronic Illness Therapy-Fatigue scale (FACIT-F). The association between fatigue and a broad set of factors within and across four symptom categories - Disease-specific,... (More)

OBJECTIVE: Fatigue is a common and debilitating non-motor symptom of Parkinson's disease (PD), arising from a complex interplaying underlying factors. While mental health and sleep are well-established evidence regarding motor symptoms, balance, gait, and cognition remain inconsistent. By explicitly examining multiple symptom domains within the same cohort, we aimed to identify which factors are most strongly associated with fatigue in PD.

METHODS: This cross-sectional study included 64 individuals with PD. Fatigue was measured using the Functional Assessment of Chronic Illness Therapy-Fatigue scale (FACIT-F). The association between fatigue and a broad set of factors within and across four symptom categories - Disease-specific, Balance and gait, Cognition, and Neuropsychiatric symptoms - was analysed using linear regression analysis.

RESULTS: The mean age was 69.3 years, and the disease duration was 7.8 years. Median motor symptom (UPDRS III) and fatigue (FACIT-F) were 14 and 35.5, respectively. Regression analyses revealed significant associations with fatigue within all four categories. In the final model, self-perceived walking difficulties were the strongest independent associated factor to fatigue, followed by depression, functional balance, dynamic balance and comfortable gait speed. Together, these factors explained 70% of the variance in fatigue.

CONCLUSION: Walking difficulties and depression, but not cognition, were key factors associated with fatigue, underscoring the interplay of motor and non-motor factors of psychological health character. These findings highlight the need for comprehensive assessments and targeted interventions to effectively manage fatigue in PD.

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author
; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Parkinsonism & Related Disorders
volume
148
article number
108358
publisher
Elsevier
external identifiers
  • pmid:42155184
  • scopus:105039085154
ISSN
1873-5126
DOI
10.1016/j.parkreldis.2026.108358
language
English
LU publication?
yes
additional info
Copyright © 2026 The Authors. Published by Elsevier Ltd.. All rights reserved.
id
a81a463c-c703-462b-aa3a-8525c01811b9
date added to LUP
2026-05-27 23:23:59
date last changed
2026-09-18 19:01:29
@article{a81a463c-c703-462b-aa3a-8525c01811b9,
  abstract     = {{<p>OBJECTIVE: Fatigue is a common and debilitating non-motor symptom of Parkinson's disease (PD), arising from a complex interplaying underlying factors. While mental health and sleep are well-established evidence regarding motor symptoms, balance, gait, and cognition remain inconsistent. By explicitly examining multiple symptom domains within the same cohort, we aimed to identify which factors are most strongly associated with fatigue in PD.</p><p>METHODS: This cross-sectional study included 64 individuals with PD. Fatigue was measured using the Functional Assessment of Chronic Illness Therapy-Fatigue scale (FACIT-F). The association between fatigue and a broad set of factors within and across four symptom categories - Disease-specific, Balance and gait, Cognition, and Neuropsychiatric symptoms - was analysed using linear regression analysis.</p><p>RESULTS: The mean age was 69.3 years, and the disease duration was 7.8 years. Median motor symptom (UPDRS III) and fatigue (FACIT-F) were 14 and 35.5, respectively. Regression analyses revealed significant associations with fatigue within all four categories. In the final model, self-perceived walking difficulties were the strongest independent associated factor to fatigue, followed by depression, functional balance, dynamic balance and comfortable gait speed. Together, these factors explained 70% of the variance in fatigue.</p><p>CONCLUSION: Walking difficulties and depression, but not cognition, were key factors associated with fatigue, underscoring the interplay of motor and non-motor factors of psychological health character. These findings highlight the need for comprehensive assessments and targeted interventions to effectively manage fatigue in PD.</p>}},
  author       = {{Lindholm, Beata and Ekman, Urban and Szymanska, Anna and Franzén, Erika}},
  issn         = {{1873-5126}},
  language     = {{eng}},
  month        = {{05}},
  publisher    = {{Elsevier}},
  series       = {{Parkinsonism & Related Disorders}},
  title        = {{Exploring fatigue in mild Parkinson's disease across symptoms - A cross-sectional study with implications for walking ability}},
  url          = {{http://dx.doi.org/10.1016/j.parkreldis.2026.108358}},
  doi          = {{10.1016/j.parkreldis.2026.108358}},
  volume       = {{148}},
  year         = {{2026}},
}