Synergy of pandemics-social isolation is associated with worsened Parkinson severity and quality of life

Abstract

Social isolation and its deleterious effects on health increases with age in the general population. People with Parkinson’s Disease (PWP) are no exception. Social isolation is a risk factor for worsened health outcomes and increased mortality. Symptoms such as depression and sleep dysfunction are adversely affected by loneliness. There is a paucity of research on social isolation in Parkinson’s disease (PD), which is all the more critical now in the setting of social distancing due to COVID-19. The goal of this study was to survey individuals with PD to evaluate whether social isolation is associated with PD symptom severity and quality of life. Only individuals reporting a diagnosis of idiopathic PD were included in this analysis. The primary outcome measures were the Patient-Reported Outcomes in PD (PRO-PD) and questions from PROMIS Global related to social health. PRO-PD scores increased as social performance and social satisfaction scores diminished. Individuals who reported being lonely experienced a 55% greater symptom severity than those who were not lonely (P < 0.01). Individuals who documented having a lot of friends had 21% fewer symptoms than those with few or no friends (P < 0.01). Social isolation was associated with greater patient-reported PD severity and lower quality of life, although it is unclear whether this is the cause and/or a consequence of the disease. In essence, the Parkinson pandemic and the pandemic of social isolation have been further compounded by the recent COVID-19 pandemic. The results emphasize the need to keep PWP socially connected and prevent loneliness in this time of social distancing. Proactive use of virtual modalities for support groups and social prescribing should be explored.

Lessons from the COVID-19 pandemic for improving outpatient neuropalliative care: A qualitative study of patient and caregiver perspectives

“…4,5 Patients and caregivers are predisposed to social isolation and the pandemic is likely exacerbating this issue with emerging evidence suggesting that it accelerates disease progression. [6][7][8][9][10][11] Palliative care for neurologic disease, or neuropalliative care, is an emerging subspecialty within palliative medicine. 12 There is a growing evidence showing that patients with neurodegenerative disease benefit from a neuropalliative approach.…”

“…4,5 Patients and caregivers are predisposed to social isolation and the pandemic is likely exacerbating this issue with emerging evidence suggesting that it accelerates disease progression. 6–11…”

How COVID-19 will boost remote exercise-based treatment in Parkinson’s disease: a narrative review

“…Due to their reduced cognitive flexibility and their dependence on regular physical exercise, they are vulnerable to serious collateral damage from the COVID-19 pandemic on their physical and mental health 11 . The combination of psychological stress and reduced physical activity can lead to a deterioration in motor symptoms that may start a vicious circle of depressed mood, lack of motivation, and further decline of mobility 38,39 . Although not infected, 10-28% of PD patients reported a worsening of their symptoms due to restricted mobility during the lockdown [40][41][42][43] .…”

Falls Prevention and Quality of Life Improvement by Square Stepping Exercise in People with Parkinson’s Disease: Project Report

“…Clinical presentations of depression share some similarities with anxiety and apathy, such as fatigue, agitation, psychomotor retardation, and difficulty concentrating [ 13 ]. In addition, apathy and depression can affect motivation to perform social functions and correlates with social isolation in PD [ 14 ].…”