Every day and Task-based Cognition in Parkinson’s Disease Predicts Emotion Regulation and Wellbeing

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Background: Cognitive dysfunction and emotional symptoms frequently co-occur in Parkinson’s disease (PD), yet the mechanisms linking these domains have yet to be clearly defined. One proposed pathway involves differences in emotion regulation (ER) strategy use, which may vary as a function of cognitive capacity. Objectives: To examine whether task-based executive functioning (EF) and self-reported functional cognitive impairment (FCI) are associated with anxiety, depression, and mental wellbeing in PD, and whether these relationships are mediated or moderated by ER strategies. Methods: 103 individuals with PD completed EF tasks, as well as self-report measures of FCI, ER strategy use, and mental health. Principal component analysis was used to derive EF components. Mediation and moderation analyses examined whether cognitive functioning predicted mental health through or in interaction with ER strategy use. Results: Worse FCI was directly associated with poorer mental health and linked to greater use of maladaptive strategies. Better task-based EF was indirectly associated with better mental health outcomes via increased use of adaptive ER strategies. The association between regulation strategies and mental health varied depending on cognitive capacity, suggesting that the effectiveness of specific strategies is contingent on underlying cognitive functioning. Conclusions: These findings identify cognitive capacity as a key underpinning of ER and its relationship to mental health outcomes in PD. By delineating distinct contributions of functional and task-based cognition, this study advances understanding of the mechanisms underlying affective symptom expression in PD and highlights the cognitive context in which non-motor symptoms emerge.

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