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White DR, Palmieri PA. There is 'no cure for caregiving': the experience of women caring for husbands living with Parkinson's disease. Int J Qual Stud Health Well-being 2024; 19:2341989. [PMID: 38657183 PMCID: PMC11044767 DOI: 10.1080/17482631.2024.2341989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 04/08/2024] [Indexed: 04/26/2024] Open
Abstract
BACKGROUND Parkinson's disease is a progressive neurodegenerative disorder. The majority of the nearly 9 million people living with Parkinson's disease are men. As such, caregiving is often assumed by wives as the disease progresses. However, there is little research about the lived experience of wives as they transition to caregivers. OBJECTIVE To describe the lived experience of wife caregivers of male spouses living at home with Parkinson's disease. METHODS A descriptive phenomenological study. Semi-structured interviews were recorded and transcribed for analysis in Atlas.ti using Colaizzi's method. RESULTS Thirteen women, aged 50 to 83 years, were interviewed. Five themes emerged from the analysis, (1) caregiver who? (2) taking it day by day, (3) not sure what to do next, (4) just too much, and (5) caring is your soul's growth, to support the central theme "there is no cure for caregiving." CONCLUSION Transitioning from wife to caregiver was a gradual but difficult process. Although the wife caregivers wanted to be part of the health care team, they remained outsiders. Clinicians need to recognize the wives as care coordinators linking medical management with home care. Policy makers need to develop reimbursement models that provide wife caregivers with support groups, education programs, and telemental health services.
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Affiliation(s)
- Dawn R. White
- College of Graduate Health Studies, A. T. Still University, Kirksville, MO, USA
- Benerd College, University of the Pacific, Stockton, CA, USA
- South American Center for Qualitative Research, Universidad Norbert Wiener, Lima, Peru
- EBHC South America: A JBI Affiliated Group, Escuela Posgrado, Universidad Nortbert Wiener, Lima, Peru
| | - Patrick A. Palmieri
- College of Graduate Health Studies, A. T. Still University, Kirksville, MO, USA
- South American Center for Qualitative Research, Universidad Norbert Wiener, Lima, Peru
- College of Nursing and Health Sciences, Excelsior University, Albany, NY, USA
- EBHC South America: A JBI Affiliated Group, Escuela Posgrado, Universidad Nortbert Wiener, Lima, Peru
- Center for Global Nursing, Texas Woman’s University, Houston, TX, USA
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Sadek AT, Djerdjour L, Reyes RA, Adams GP, Logan CH, Smith MA, Biddle SG, Wiles TS, Urrea-Mendoza E, McConnell TM, Revilla FJ, Trilk JL. The Feasibility and Efficacy of a Virtual Reality Tandem Cycling Program for Persons with Parkinson's Disease and Their Care Partners. Neurol Ther 2024; 13:1237-1257. [PMID: 38878129 PMCID: PMC11263444 DOI: 10.1007/s40120-024-00636-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2024] [Accepted: 05/30/2024] [Indexed: 07/23/2024] Open
Abstract
INTRODUCTION Persons with Parkinson's disease (PwPD) suffer from motor and non-motor symptoms which significantly affect their quality of life (QoL), and the QoL of their care partners (CP). Tandem cycling reduces PwPD motor symptoms; however, no studies have examined other benefits or included PwPD CP. We conducted an 8-week community virtual reality (VR) tandem cycling intervention to assess the feasibility and efficacy for PwPD and their CP (i.e., PD dyads). We hypothesized that dyadic tandem cycling would improve (1) PwPD motor and non-motor symptoms and (2) dimensions of PD dyads' QoL and physiologic health. METHODS Ten PD dyads were recruited to complete 8 weeks of progressive intensity, bi-weekly tandem cycling. At pre- and post-testing, PwPD were assessed using the Movement Disorder Society-Unified Parkinson's Disease Rating Scale-III (MDS-UPDRS-III), functional gait assessment (FGA), and 10-m gait speed test. PD dyads also completed emotional and cognitive status questionnaires [e.g., Geriatric Depression Scale-Short Form (GDS-SF)], and wore BodyGuard 2 heart rate (HR) monitors for 48 h to assess surrogate measures of heart rate variability. Statistical analyses were conducted using Student's t tests with significance set at p ≤ 0.05. RESULTS Eight PD dyads and one PwPD completed the intervention. Retention of PwPD (90%) and CP (80%) was adequate, and PD dyad adherence ranged from 91.67 to 97.91%. PwPD demonstrated significant clinical improvements in MDS-UPDRS-III scores (- 7.38, p < 0.01), FGA scores (+ 3.50, p < 0.01), and 10-m gait speed times (+ 0.27 m/s, p < 0.01), in addition to significant self-reported improvements in mobility (- 13.61, p = 0.02), fatigue (- 5.99, p = 0.02), and social participation (+ 4.69, p < 0.01). CP depressive symptoms significantly decreased (- 0.88, p = 0.02), and PD dyads shared a significant increase in root mean square of the successive differences (RMSSD; p = 0.04). CONCLUSION Our pilot study demonstrated feasibility and multiple areas of efficacy supporting further investigation of community VR tandem cycling as a therapeutic intervention for PD dyads.
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Affiliation(s)
- Alia T Sadek
- Department of Biomedical Sciences, University of South Carolina School of Medicine Greenville, 607 Grove Road, Greenville, SC, 29605, USA.
| | - Leila Djerdjour
- Department of Biomedical Sciences, University of South Carolina School of Medicine Greenville, 607 Grove Road, Greenville, SC, 29605, USA
| | - Ryan A Reyes
- Department of Biomedical Sciences, University of South Carolina School of Medicine Greenville, 607 Grove Road, Greenville, SC, 29605, USA
| | - Greggory P Adams
- Department of Biomedical Sciences, University of South Carolina School of Medicine Greenville, 607 Grove Road, Greenville, SC, 29605, USA
| | - Cara H Logan
- Department of Biomedical Sciences, University of South Carolina School of Medicine Greenville, 607 Grove Road, Greenville, SC, 29605, USA
| | - Margaret A Smith
- Department of Biomedical Sciences, University of South Carolina School of Medicine Greenville, 607 Grove Road, Greenville, SC, 29605, USA
| | - Sara G Biddle
- Department of Biomedical Sciences, University of South Carolina School of Medicine Greenville, 607 Grove Road, Greenville, SC, 29605, USA
| | | | - Enrique Urrea-Mendoza
- Department of Clinical Science/TMH Physicians Partners, Medical School, Florida State University, Tallahassee, FL, USA
| | - Tracie M McConnell
- Department of Biomedical Sciences, University of South Carolina School of Medicine Greenville, 607 Grove Road, Greenville, SC, 29605, USA
- Neuroscience Associates, Prisma Health-Upstate, Greenville, SC, USA
| | - Fredy J Revilla
- Department of Biomedical Sciences, University of South Carolina School of Medicine Greenville, 607 Grove Road, Greenville, SC, 29605, USA
- Neuroscience Associates, Prisma Health-Upstate, Greenville, SC, USA
| | - Jennifer L Trilk
- Department of Biomedical Sciences, University of South Carolina School of Medicine Greenville, 607 Grove Road, Greenville, SC, 29605, USA
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Kleinholdermann U, Thieken F, Ruppert-Junck MC, van Munster M, Pedrosa AJ, Stümpel J, Hammes V, Timmermann L, Woopen C, Schmitz-Luhn B, Storms A, Golla H, Nater UM, Skoluda N, Pfefferle PI, Pedrosa DJ. Study protocol of the HessenKohorte2042: a prospective, longitudinal cohort study characterising quality of life in people with Parkinson's disease and their caregivers using a bio-psycho-social approach. BMJ Open 2024; 14:e080475. [PMID: 39067880 DOI: 10.1136/bmjopen-2023-080475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/30/2024] Open
Abstract
INTRODUCTION Quality of life (QoL) is of paramount importance as an outcome to monitor and guide therapies for people with Parkinson's disease (PwPD). In particular, due to the heterogeneous symptoms that PwPD may experience during their disease course, QoL can deteriorate not only in patients but also in their caregivers, with a variety of psychosocial consequences. However, there is a lack of longitudinal studies that explore how QoL evolves over time and what factors are significant. Furthermore, holistic approaches that consider bio-psycho-social determinants are rare. In the worst cases, these gaps can lead to suboptimal care and therefore unmet needs for patients and their caregivers, resulting in unnecessary symptom burden and increased healthcare costs for society. METHODS AND ANALYSIS This prospective, longitudinal study will follow 1000 PwPD along with their caregivers for 20 years, with up to 40 semi-annual assessments. Patient data and sample collection will include clinical assessments, self-reported outcome measures focusing on QoL, biospecimen collection and MRI. Caregiver burden will be systematically assessed through self-administered questionnaires. The use of digitised surveys will allow efficient data collection and convenient assessment at home. Our primary objective is to attain a holistic understanding of QoL in PwPD and establish a tool to measure it. The secondary objective is to explore the psycho-social and biological variables associated with QoL of patients and caregivers over the progression of the disease. This will provide key information for diagnostic and prognostic prediction, therapeutic patient stratification and adaptation of therapy in the future. ETHICS AND DISSEMINATION The study was approved by the local ethics committee of the University Hospital of Marburg (study number: 209/19). The results will be disseminated by means of publication in peer-reviewed journals, international conference contributions, annual patient meetings and a dedicated website. TRIAL REGISTRATION NUMBER German Clinical Trials Register (DRKS00023598).
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Affiliation(s)
| | | | - Marina Christine Ruppert-Junck
- Philipps-Universitat Marburg, Marburg, Germany
- Center of Mind, Brain and Behaviour, Philipps-Universitat Marburg, Marburg, Germany
| | - Marlena van Munster
- Philipps-Universitat Marburg, Marburg, Germany
- Care and Public Health Research Institute, Maastricht University, Maastricht, Netherlands
| | | | - Johanne Stümpel
- Philipps-Universitat Marburg, Marburg, Germany
- Center for Life Ethics, University of Bonn, Bonn, Germany
| | | | - Lars Timmermann
- Philipps-Universitat Marburg, Marburg, Germany
- Center of Mind, Brain and Behaviour, Philipps-Universitat Marburg, Marburg, Germany
| | | | | | - Anna Storms
- Katholische Akademie Die Wolfsburg, Diocese of Essen, Mülheim an der Ruhr, Germany
| | - Heidrun Golla
- Department of Palliative Medicine, University Hospital Cologne, Cologne, Germany
| | - Urs M Nater
- Department of Psychology, University of Vienna, Vienna, Austria
| | - Nadine Skoluda
- Department of Psychology, University of Vienna, Vienna, Austria
| | - Petra Ina Pfefferle
- Comprehensive Biobank Marburg (CBBMR), Philipps-Universität Marburg, Marburg, Germany
| | - David José Pedrosa
- Philipps-Universitat Marburg, Marburg, Germany
- Center of Mind, Brain and Behaviour, Philipps-Universitat Marburg, Marburg, Germany
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Senter M, Clifford AM, Bhriain ON. Using theory knitting to conceptualize social phenomena in the design and evaluation of dance programs for people living with Parkinson's disease. EVALUATION AND PROGRAM PLANNING 2024; 104:102430. [PMID: 38581972 DOI: 10.1016/j.evalprogplan.2024.102430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Revised: 03/30/2024] [Accepted: 04/01/2024] [Indexed: 04/08/2024]
Abstract
Dance programs for people living with Parkinson's disease (PwPD) offer participants an opportunity to exercise, engage in artistic self-expression, and form new relationships. While it is understood that the social dimension of dance programs for PwPD contributes to dancer satisfaction and program sustainability, the social mechanisms instrumental to program success are under-examined. Engaging with theory from wider disciplines, or "theory knitting" can help program designers and evaluators examine the mechanisms and contextual factors that make classes socially meaningful with greater detail and specificity. This study identified and examined three theoretical frameworks that program planners and evaluators could use to conceptualize social engagement in dance for PwPD contexts and inform practice. Each theory was assessed for fit using the T-CaST theory comparison and selection tool developed by Birken et al. (2018). As an example, we used anthropologist Victor Turner's (1970; 1977) theory of liminality and communitas to identify five key areas for fostering a sense of social connection in dance for PwPD contexts: (1) selecting a meaningful dance space (2) creating a joyous atmosphere (3) marking entrance into the liminal time and space with rituals (4) embodying liminality and anti-structure and (5) inverting power relations and embracing fluid roles.
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Affiliation(s)
- Morgan Senter
- Irish World Academy of Music and Dance, Faculty of Arts, Humanities, and Social Sciences, University of Limerick, Co. Limerick, Ireland.
| | - Amanda M Clifford
- School of Allied Health, Faculty of Education and Health Sciences, University of Limerick, Co. Limerick, Ireland; Health Research Institute, University of Limerick, Co. Limerick, Ireland; Ageing Research Centre, University of Limerick, Co. Limerick, Ireland
| | - Orfhlaith Ni Bhriain
- Irish World Academy of Music and Dance, Faculty of Arts, Humanities, and Social Sciences, University of Limerick, Co. Limerick, Ireland; Health Research Institute, University of Limerick, Co. Limerick, Ireland
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Delabary MDS, Loch Sbeghen I, Teixeira da Silva EC, Guzzo Júnior CCE, Nogueira Haas A. Brazilian dance self-perceived impacts on quality of life of people with Parkinson's. Front Psychol 2024; 15:1356553. [PMID: 38449766 PMCID: PMC10914939 DOI: 10.3389/fpsyg.2024.1356553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 01/29/2024] [Indexed: 03/08/2024] Open
Abstract
Background Parkinson's disease (PD) causes several motor and non-motor symptoms, resulting in negative impacts on physical, mental, emotional, and social aspects of people with PD quality of life. Dance has been considered as a potential non-pharmacological intervention to improve people with PD motor and non-motor symptoms, thereby enhancing quality of life. Purpose To analyze the self-perceive impacts of Brazilian Dance on the quality of life (physical, mental, emotional, and social) of PwPD, both before and during the COVID-19 pandemic. Methods Fourteen participants from the "Dança & Parkinson" project were included in this qualitative study. Data collection instruments consisted of a profile and personal data sheet; assessment of accessibility to the online dance classes; Telephone Montreal Cognitive Assessment by phone call; and semi-structured interview conducted through ZOOM video call. The participants characterization data were calculated using mean, standard deviation, and percentages with the Excel Program version 2013. Qualitative data was analyzed using the Thematic Analysis technique in the Nvivo, version 8.0, qualitative analysis of text, sound, and video program. Results The participants reported facing various challenges in dealing with PD, which negatively impact their quality of life. However, their resilience, acceptance, and dedication to treatment play an important role in coping with the issues related to the disease. Brazilian dance, both in-person before the COVID-19 pandemic and online during the pandemic, led the participants to perceive improvements in physical, mental, emotional, and social aspects of quality of life. Conclusion The Brazilian dance appears to have a positive impact on the physical, mental, emotional, and social aspects of the participants' quality of life, both before and during the COVID-19 pandemic.
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Affiliation(s)
- Marcela dos Santos Delabary
- Department of Physical Education, Physiotherapy and Dance, Federal University of Rio Grande do Sul, Rio Grande do Sul, Brazil
| | - Isadora Loch Sbeghen
- Department of Physical Education, Physiotherapy and Dance, Federal University of Rio Grande do Sul, Rio Grande do Sul, Brazil
| | | | | | - Aline Nogueira Haas
- Department of Physical Education, Physiotherapy and Dance, Federal University of Rio Grande do Sul, Rio Grande do Sul, Brazil
- Atlantic Fellow for Equity in Brain, Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland
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6
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Tosin MH, Goetz CG, Stebbins GT. Patient With Parkinson Disease and Care Partner Perceptions of Key Domains Affecting Health-Related Quality of Life: Systematic Review. Neurology 2024; 102:e208028. [PMID: 38215353 PMCID: PMC11097757 DOI: 10.1212/wnl.0000000000208028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 10/16/2023] [Indexed: 01/14/2024] Open
Abstract
BACKGROUND AND OBJECTIVES To effectively customize Parkinson disease (PD) programs, it is important to incorporate the "individual's voice" and have a thorough understanding of the symptom priorities of people with PD (PwP) and care partners (CP). In this convergent integrated mixed-method systematic review, we aimed to analyze qualitative and quantitative evidence of PD motor and nonmotor symptoms affecting health-related quality of life (HRQOL) in PwP and CP, comparing priorities across different levels of disease severity. METHODS We searched MEDLINE, PsycINFO, Web of Science, Embase, and Scopus; ProQuest Dissertations and Theses Global; and the Michael J. Fox Foundation Data Resources for studies published up to June 29, 2022. We included qualitative, quantitative, and mixed-method studies investigating PD symptom priorities among PwP and CP. We critically appraised eligible studies for methodological quality using the Mixed-Methods Appraisal Tool. Derived terms were mapped and coded according to thematic attribution. Independent syntheses of qualitative and quantitative evidence and transformation of quantitative data into qualitative formats were performed. RESULTS Of the 7,716 identified studies, we included 70 that provided qualitative (n = 13), quantitative (n = 53), and mixed (n = 4) evidence. We included 604 mapped terms representing 11 PwP-identified and CP-identified motor and nonmotor symptom categories. Across all PD stages, both PwP and CP considered 5 domains more affecting their HRQOL, namely: "motor functionality," "mood," "cognition," "gait, balance, posture, and falls," and "nighttime sleep disorders." In early disease, PwP and CP considered "mood" the domain that most affected their HRQOL. In advanced PD, PwP considered "pain" the domain that most affects their HRQOL, while CP considered "psychiatric symptoms." The domain "gait, balance, posture, and falls" was equally considered by both PwP and CP as the second domain that most affects their HRQOL in the advanced stage of PD. DISCUSSION The ranking of the priority of symptoms is largely shared by PwP and CP, and motor symptom priorities dominate the full disease spectrum. However, the nonmotor symptom priorities shift according to the disease severity stage. Tailored care and research require that providers consider these shifting priorities and incorporate the "individual's voice" into treatment decisions.
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Affiliation(s)
- Michelle H Tosin
- From the Department of Neurological Sciences, Rush University, Chicago, IL
| | | | - Glenn T Stebbins
- From the Department of Neurological Sciences, Rush University, Chicago, IL
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Fekonja Z, Irgolič N, Vrbnjak D. Family members' experiences of everyday caregiving for a family member living with Parkinson's disease: a qualitative thematic analysis study. BMC Nurs 2024; 23:98. [PMID: 38321424 PMCID: PMC10845758 DOI: 10.1186/s12912-024-01767-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 01/25/2024] [Indexed: 02/08/2024] Open
Abstract
BACKGROUND In the daily life of individuals living with Parkinson's disease, their loved ones are crucial. Adapting family members to the patient's condition, support in providing care, and psychosocial adaptations is essential. AIM To explore family members' perception of everyday caregiving for a family member living with Parkinson's disease and to describe their role in the care and everyday life. METHODS In a descriptive, qualitative thematic analysis study, semi-structured interviews were conducted with ten people between the ages of 20 and 70, the closest family members of people living with Parkinson's disease. The analysis of the collected data was carried out using thematic analysis. RESULTS We generated the main theme: "Living with a family member with Parkinson's disease", with associated secondary-level sub-themes: "Response", "Change", "Care", and "Support". Family members of individuals living with Parkinson's disease frequently encounter similar life situations. The most notable transformation in their daily lives primarily revolves around adapting to various activities. CONCLUSIONS Family members are the ones who most often take on the role of caregiver and provide help to their loved ones. Many of them accept the disease as a part of everyday life and learn to live with it. It is of fundamental importance that we offer family members the necessary support, knowledge, and involvement in holistic treatment and care.
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Affiliation(s)
- Zvonka Fekonja
- Faculty of Health Sciences, University of Maribor, Žitna Ulica 15, 2000, Maribor, SI, Slovenia.
| | - Nadja Irgolič
- Dom Danice Vogrinec Maribor, Unit Tabor, Čufarjeva Cesta 9, 2000, Maribor, SI, Slovenia
| | - Dominika Vrbnjak
- Faculty of Health Sciences, University of Maribor, Žitna Ulica 15, 2000, Maribor, SI, Slovenia
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Thangavel G, Memedi M, Hedström K. Information and Communication Technology for Managing Social Isolation and Loneliness Among People Living With Parkinson Disease: Qualitative Study of Barriers and Facilitators. J Med Internet Res 2024; 26:e48175. [PMID: 38231548 PMCID: PMC10831595 DOI: 10.2196/48175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 08/17/2023] [Accepted: 11/20/2023] [Indexed: 01/18/2024] Open
Abstract
BACKGROUND Parkinson disease (PD) is a complex, noncurable, and progressive neurological disease affecting different areas of the human nervous system. PD is associated with both motor and nonmotor symptoms, which negatively affect patients' quality of life and may cause changes in socialization such as intentional social withdrawal. This may further lead to social isolation and loneliness. The use of information and communication technology (ICT) plays an important role in managing social isolation and loneliness. Currently, there is a lack of research focusing on designing and developing ICT solutions that specifically address social isolation and loneliness among people living with PD. OBJECTIVE This study addresses this gap by investigating barriers and social needs in the context of social isolation, loneliness, and technology use among people living with PD. The insights gained can inform the development of effective ICT solutions, which can address social isolation and loneliness and improve the quality of life for people living with PD. METHODS A qualitative study with 2 phases of data collection were conducted. During the first phase, 9 health care professionals and 16 people living with PD were interviewed to understand how PD affects social life and technology use. During the second phase, 2 focus groups were conducted with 4 people living with PD in each group to gather insights into their needs and identify ways to manage social isolation and loneliness. Thematic analysis was used to analyze both data sets and identify key themes. RESULTS The results showed that the barriers experienced by people living with PD due to PD such as "fatigue," "psychological conditions," "social stigma," and "medication side effects" affect their social life. People living with PD also experience difficulties using a keyboard and mouse, remembering passwords, and navigating complex applications due to their PD-related physical and cognitive limitations. To manage their social isolation and loneliness, people living with PD suggested having a simple and easy-to-use solution, allowing them to participate in a digital community based on their interests, communicate with others, and receive recommendations for social events. CONCLUSIONS The new ICT solutions focusing on social isolation and loneliness among people living with PD should consider the barriers restricting user's social activities and technology use. Given the wide range of needs and barriers experienced by people living with PD, it is more suitable to adopt user-centered design approaches that emphasize the active participation of end users in the design process. Importantly, any ICT solution designed for people living with PD should not encourage internet addiction, which will further contribute to the person's withdrawal from society.
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Affiliation(s)
- Gomathi Thangavel
- Centre for Empirical Research on Information Systems, Örebro University School of Business, Örebro, Sweden
| | - Mevludin Memedi
- Centre for Empirical Research on Information Systems, Örebro University School of Business, Örebro, Sweden
- College of Business, Alfaisal University, Riyadh, Saudi Arabia
| | - Karin Hedström
- Centre for Empirical Research on Information Systems, Örebro University School of Business, Örebro, Sweden
- Department of Communication, Quality Management and Information Systems, Mid Sweden University, Sundsvall, Sweden
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Glover L, Dixon C, Kobylecki C, Eccles FJR. Parkinson's and the couple relationship: a qualitative meta-synthesis. Aging Ment Health 2023; 27:2420-2429. [PMID: 37354064 DOI: 10.1080/13607863.2023.2227119] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 06/08/2023] [Indexed: 06/26/2023]
Abstract
OBJECTIVE The aim was to synthesise the current qualitative literature on the impact of Parkinson's on the couple relationship, including individual and dyad studies. METHODS Noblit and Hare's meta-ethnography approach was applied; 19 studies were included in the review following a systematic search of four electronic databases. The studies included experiences of 137 People with Parkinson's and 191 partners. FINDINGS Analysis produced three themes: (1) Disruption of roles and responsibilities; (2) Challenges to communication and closeness; and (3) Grief, burden, and isolation. The themes are discussed with supporting extracts from the 19 included studies. CONCLUSION The findings highlight the challenges that couples experience and the individual and relational resources that support coping. Support should be individually tailored to each couple as the impact on the couple may change in response to individual and contextual factors. This review adds further evidence to the case for relationally focused multidisciplinary team input at all stages of Parkinson's disease.
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Affiliation(s)
- Louise Glover
- Lancaster University, Health Innovation One, Sir John Fisher Drive, Lancaster University, Lancaster, UK
| | - Clare Dixon
- Lancaster University, Health Innovation One, Sir John Fisher Drive, Lancaster University, Lancaster, UK
| | - Christopher Kobylecki
- Manchester Centre for Clinical Neurosciences, Northern Care Alliance NHS Foundation Trust, Stott Lane, Salford, UK
- Division of Neuroscience and Experimental Psychology, University of Manchester, Manchester, UK
| | - Fiona J R Eccles
- Lancaster University, Health Innovation One, Sir John Fisher Drive, Lancaster University, Lancaster, UK
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Mavandadi S, Interian A, Sayers S, Dobkin R, Weintraub D. Social Control and Health Behaviors Among Individuals Living with Parkinson's Disease: A Pilot Study. Int J Behav Med 2023:10.1007/s12529-023-10219-5. [PMID: 37783869 DOI: 10.1007/s12529-023-10219-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/04/2023] [Indexed: 10/04/2023]
Abstract
BACKGROUND Positive health behaviors (e.g., exercise, healthy eating habits, good sleep hygiene, treatment adherence) are important in ensuring optimal symptom management and health outcomes among individuals living with Parkinson's disease (PD). While multiple factors may influence engagement in health behaviors, little is known about the occurrence of social control, or relationship partners' attempts to influence and regulate another's behavior, and its potential role in the adoption of health behaviors among individuals with PD. METHODS To better understand the types of social control attempts employed and begin to explore the association between social control attempts and behavioral responses (e.g., engage in the targeted health behavior, hide the behavior) to those attempts, survey data were drawn from a cross-sectional, pilot study of married/partnered Veterans diagnosed with idiopathic PD (n = 25). Participants completed self-reported measures of sociodemographics, physical and mental well-being, relationship functioning, and both the frequency of and behavioral responses to positive and negative social control attempts. RESULTS Although the majority of individuals reported their partners engaged in positive social control attempts, half also reported negative attempts. Bivariate analyses revealed more frequent positive social control attempts from one's partner were related to both positive and negative behavioral responses, and negative social control attempts were related to negative behavioral responses. However, when adjusting for covariates, positive social control attempts were related to positive behavioral responses, while negative social exchanges with one's partner (e.g., general conflict), rather than exposure to negative social control attempts, were related to negative behavioral responses. CONCLUSIONS Findings lend preliminary evidence of the relationship between social control and exchanges and health behavior that may inform future, adequately powered observational and intervention studies that target interpersonal processes and health behaviors among individuals living with PD and their relationship partners.
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Affiliation(s)
- Shahrzad Mavandadi
- Center for Scientific Review, National Institutes of Health, 6701 Rockledge Drive, Bethesda, MD, 20892, USA.
- Mental Illness Research, Education and Clinical Center, Corporal Michael J. Crescenz VA Medical Center, 3900 Woodland Avenue, Philadelphia, PA, 19104, USA.
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
| | - Alejandro Interian
- Mental Health and Behavioral Sciences, VA New Jersey Healthcare System, Lyons, NJ, USA
| | - Steven Sayers
- Mental Illness Research, Education and Clinical Center, Corporal Michael J. Crescenz VA Medical Center, 3900 Woodland Avenue, Philadelphia, PA, 19104, USA
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Roseanne Dobkin
- Department of Psychiatry, Rutgers-Robert Wood Johnson Medical School, Piscataway, NJ, USA
| | - Daniel Weintraub
- Mental Illness Research, Education and Clinical Center, Corporal Michael J. Crescenz VA Medical Center, 3900 Woodland Avenue, Philadelphia, PA, 19104, USA
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Parkinson's Disease Research, Education and Clinical Center, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA, USA
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Pedrosa AJ, van Munster M, Timmermann L, Pedrosa DJ. Safety perception in patients with advanced idiopathic Parkinson's disease - a qualitative study. Front Aging Neurosci 2023; 15:1200143. [PMID: 37744397 PMCID: PMC10513089 DOI: 10.3389/fnagi.2023.1200143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 08/18/2023] [Indexed: 09/26/2023] Open
Abstract
Background A fundamental cornerstone of quality of healthcare is patient safety, which many people with life-limiting illnesses feel is being compromised. Perceptions of impaired safety are associated with the occurrence of psychological distress and healthcare utilization. However, little is known about how people with idiopathic Parkinson's disease (iPD) perceive their own safety toward the end of life. The aim of our study was therefore to investigate factors that influence the perception of safety of patients with advanced iPD. Methods We conducted semi-structured interviews with a purposeful sample of 21 patients with advanced iPD. Participants were recruited at the neurology department of a tertiary care hospital in Germany between August 2021 and June 2022. Data were analyzed using reflexive thematic analysis. Results iPD-patients reported relevant impairment of their safety. While most participants expressed safety concerns based on the manifestation of disease, our analysis identified enablers and barriers to establishing safety in patients with advanced iPD, in 10 additional domains: relationship to the disease, informedness, self-perception, utilization of support and care structures, healthcare professionals and structures, treatment, social interaction, social security, spirituality, and environment. Conclusion This study provides new insights into safety perceptions of patients with advanced iPD, which extend well beyond the physical realm. The findings suggest that clinicians and policy makers should consider a holistic and multidisciplinary approach to assessing and improving patients' safety taking into account the enablers and barriers identified in this study.
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Affiliation(s)
- Anna J. Pedrosa
- Department of Neurology, University Hospital Giessen and Marburg, Marburg, Germany
| | - Marlena van Munster
- Department of Neurology, University Hospital Giessen and Marburg, Marburg, Germany
- Department of International Health, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, Netherlands
| | - Lars Timmermann
- Department of Neurology, University Hospital Giessen and Marburg, Marburg, Germany
- Centre for Mind, Brain and Behaviour, Philipps-University Marburg, Marburg, Germany
| | - David J. Pedrosa
- Department of Neurology, University Hospital Giessen and Marburg, Marburg, Germany
- Centre for Mind, Brain and Behaviour, Philipps-University Marburg, Marburg, Germany
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Hesam Shariati F, Steffens A, Adhami S. Designing environments that contribute to a reduction in the progression of Parkinson's disease; a literature review. Health Place 2023; 83:103105. [PMID: 37703785 DOI: 10.1016/j.healthplace.2023.103105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 07/19/2023] [Accepted: 08/16/2023] [Indexed: 09/15/2023]
Abstract
Parkinson's Disease (PD), a prevalent neurological disorder, causes physical difficulties like stiffness and impaired walking and affects patients' emotional well-being. Regular exercise and exposure to enriched environments are crucial to managing these symptoms. This review aims to extract evidence from studies regarding built environments' impact on reducing the progression of PD. Keywords from 2005 to 2022 were used in five databases, including PubMed, Clarivate Web of Science, UGA Library, and Google Scholar. Many studies emphasized physiotherapy and training for physical enhancement, often utilizing virtual games and smart devices. Others highlighted the advantages of non-slip flooring and accessible outdoor spaces, with some based on universal design principles. Few studies considered the emotional impact of built environments, showing a considerable gap in the studies simultaneously evaluating psychological and physical perspectives of Parkinson-friendly environments. There needs to be more consistency when considering these aspects of planning. Our findings suggest future research modeling enriched environments and tracking their impact on patients via Virtual Reality to find a comprehensive guideline for the most effective PD management environments.
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Affiliation(s)
| | - Ashley Steffens
- College of Environment and Design, University of Georgia, Athens, United States
| | - Sadaf Adhami
- Department of Architecture and Design, Polytechnic University of Turin, Turin, Italy
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Bovenzi R, Conti M, Degoli GR, Cerroni R, Simonetta C, Liguori C, Salimei C, Pisani A, Pierantozzi M, Stefani A, Mercuri NB, Schirinzi T. Shaping the course of early-onset Parkinson's disease: insights from a longitudinal cohort. Neurol Sci 2023; 44:3151-3159. [PMID: 37140831 PMCID: PMC10415517 DOI: 10.1007/s10072-023-06826-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 04/20/2023] [Indexed: 05/05/2023]
Abstract
INTRODUCTION Early -onset Parkinson's disease (EOPD) labels those cases with onset earlier than fifty. Although peculiarities emerged either in clinical or pathological features, EOPD is managed alike typical, late-onset PD. A customized approach would be, instead, better appropriate. Accordingly, a deeper characterization of the clinical course, with an estimation of the disease progression rate, the therapy flow, and the main motor and non-motor complications occurrence, is needed. METHODS A longitudinal cohort of 193 EOPD patients (selected on a single-centre population of 2000 PD cases) was retrospectively analysed, providing descriptive statics on a series of clinical parameters (genetics, phenotype, comorbidities, therapies, motor and non-motor complications, marital and gender issues) and modelling the trajectories from diagnosis to 10 years later of both Hoehn and Yahr (H&Y) stage and levodopa equivalent daily dose (LEDD). RESULTS EOPD had a prevalence of 9.7%, including few monogenic cases. It mostly appeared as a motor syndrome, with asymmetric, rigid-akinetic presentation. H&Y linearly progressed with an increment of 0.92 points/10 years; LEDD flow had a non-linear trend, increasing of 526.90 mg/day in 0-5 years, and 166.83 mg/day in 5-10 years. Motor fluctuations started 6.5 ± 3.2 years from onset, affecting up to 80% of the cohort. Neuropsychiatric troubles interested the 50%, sexual complaints the 12%. Gender-specific motor disturbances emerged. CONCLUSION We shaped EOPD course, modelling a "brain-first" PD subtype, slowly progressive, with non-linear dopaminergic requirement. Major burden mostly resulted from motor fluctuations, neuropsychiatric complications, sexual and marital complaints, with a considerable gender-effect.
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Affiliation(s)
- Roberta Bovenzi
- Unit of Neurology, Department of Systems Medicine, University of Rome "Tor Vergata", Via Montpellier, 00133, Rome, Italy
| | - Matteo Conti
- Unit of Neurology, Department of Systems Medicine, University of Rome "Tor Vergata", Via Montpellier, 00133, Rome, Italy
| | - Giulia Rebecca Degoli
- Unit of Neurology, Department of Systems Medicine, University of Rome "Tor Vergata", Via Montpellier, 00133, Rome, Italy
| | - Rocco Cerroni
- Unit of Neurology, Department of Systems Medicine, University of Rome "Tor Vergata", Via Montpellier, 00133, Rome, Italy
| | - Clara Simonetta
- Unit of Neurology, Department of Systems Medicine, University of Rome "Tor Vergata", Via Montpellier, 00133, Rome, Italy
| | - Claudio Liguori
- Unit of Neurology, Department of Systems Medicine, University of Rome "Tor Vergata", Via Montpellier, 00133, Rome, Italy
| | - Chiara Salimei
- Unit of Neurology, Department of Systems Medicine, University of Rome "Tor Vergata", Via Montpellier, 00133, Rome, Italy
| | - Antonio Pisani
- Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy
- IRCCS Mondino Foundation, Pavia, Italy
| | - Mariangela Pierantozzi
- Unit of Neurology, Department of Systems Medicine, University of Rome "Tor Vergata", Via Montpellier, 00133, Rome, Italy
| | - Alessandro Stefani
- Unit of Neurology, Department of Systems Medicine, University of Rome "Tor Vergata", Via Montpellier, 00133, Rome, Italy
- UOSD Parkinson Centre, Tor Vergata University Hospital, Rome, Italy
| | - Nicola Biagio Mercuri
- Unit of Neurology, Department of Systems Medicine, University of Rome "Tor Vergata", Via Montpellier, 00133, Rome, Italy
- IRCCS Fondazione Santa Lucia, European Centre for Brain Research, Rome, Italy
| | - Tommaso Schirinzi
- Unit of Neurology, Department of Systems Medicine, University of Rome "Tor Vergata", Via Montpellier, 00133, Rome, Italy.
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14
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Prell T, Schönenberg A, Heimrich KG. The impact of loneliness on quality of life in people with Parkinson's disease: results from the Survey of Health, Ageing and Retirement in Europe. Front Med (Lausanne) 2023; 10:1183289. [PMID: 37425329 PMCID: PMC10326722 DOI: 10.3389/fmed.2023.1183289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 06/05/2023] [Indexed: 07/11/2023] Open
Abstract
Background Loneliness is a growing issue for public health in an aging society. However, there is a lack of research on loneliness in people with Parkinson's disease (PwPD). Methods We analyzed cross-sectional and longitudinal data from wave 5 (N = 559 PwPD) and 6 (N = 442 PwPD) from the Survey of Health, Ageing and Retirement in Europe (SHARE). Loneliness was assessed using the three-item version of the Revised UCLA Loneliness Scale. Descriptive statistics, group comparisons, multiple linear regressions, and generalized estimating equation analysis were performed to explore loneliness prevalence, its relationship with other factors, and its impact on Quality of Life (QoL) in PwPD. Results Depending on the used cut-off, the prevalence of loneliness in PwPD ranged from 24.1 to 53.8%. These prevalences were higher compared to people without PD. Loneliness was mainly linked to decreased functional abilities, weaker grip strength, more symptoms of depression, and country of residence. Loneliness was also associated with current QoL and predicts future QoL in PwPD, highlighting its impact on well-being. Conclusion Addressing loneliness could potentially improve QoL for PwPD, making it a modifiable risk factor that clinicians and policy-makers should consider.
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Affiliation(s)
- Tino Prell
- Department of Geriatrics, Halle University Hospital, Halle, Germany
- Department of Neurology, Jena University Hospital, Jena, Germany
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15
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Rider JV, Longhurst JK, Navalta JW, Young DL, Landers MR. Fear of Falling Avoidance Behavior in Parkinson's Disease: Most Frequently Avoided Activities. OTJR-OCCUPATION PARTICIPATION AND HEALTH 2023; 43:228-236. [PMID: 35773954 DOI: 10.1177/15394492221106103] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Fear of falling avoidance behavior (FFAB) is common in Parkinson's disease (PD). OBJECTIVES The objectives of the study are to determine what activities are most avoided due to FFAB among people with PD and whether any associations exist with demographic factors or fall history. METHOD Cross-sectional analysis of 174 individuals with PD using the Modified FFAB Questionnaire. RESULTS Walking in dimly lit, unfamiliar places, and different surfaces, lifting and carrying objects, walking in crowded places, recreational/leisure activities, and going up/downstairs were most avoided. Fallers reported more FFAB (ps < .029). FFAB for certain activities was associated with increased or decreased odds of falling. CONCLUSION Individuals with PD avoid walking in compromised situations and engaging in recreational/leisure activities due to FFAB. While excessive FFAB may increase the odds of falling, protective forms may be associated with decreased odds. Targeting FFAB among individuals with PD may increase safe participation in meaningful occupations in the home and community.
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Affiliation(s)
- John V Rider
- Touro University Nevada, Henderson, NV, USA.,University of Nevada, Las Vegas, NV, USA
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16
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Göttgens I, Modderkolk L, Jansen C, Darweesh SKL, Bloem BR, Oertelt-Prigione S. The salience of gender in the illness experiences and care preferences of people with Parkinson's disease. Soc Sci Med 2023; 320:115757. [PMID: 36738652 DOI: 10.1016/j.socscimed.2023.115757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 01/29/2023] [Accepted: 01/30/2023] [Indexed: 02/04/2023]
Abstract
RATIONALE In recent years, interest in sex characteristics and gender dimensions of Parkinson's disease (PD) has increased. Yet, much remains to be understood about how gender-related aspects specifically impact the illness and experiences of care in persons living with PD. OBJECTIVE The purpose of this study was to explore the salience of gender-related aspects in the illness experiences and care provision preferences of people with PD. METHODS A descriptive qualitative study including semi-structured life story interviews was conducted with men and women living with PD in the Netherlands. Between September 2020 and February 2021, forty people with PD (20 men and 20 women) participated in digital interviews of which thirty-one (18 men and 13 women) were included in the thematic analyses for this specific study. RESULTS Overall, most participants did not consider gender-related aspects salient towards their illness experiences. However, when prompted, a number of participants described several stereotypical views about gender as related to the visibility of PD, emotional experiences, help seeking, role patterns and physical appearance. While most men and women with PD did not express specific gender-related preferences for their healthcare providers, those that did, all preferred women as healthcare providers. These preferences were generally related to attributed feminine traits which are considered relevant in routine, particularly sensitive, physical examinations of people with PD. CONCLUSION This study demonstrates that although every person has a gender identity, the salience attributed to gender varies with illness experiences and in care provision preferences between people with PD. These findings highlight the need for precise and personalized methodologies to capture more nuanced insights into the impact of gender dimensions on PD. Furthermore, drivers behind gender-related preferences in care provision are multifactorial and warrant further investigation among people with PD.
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Affiliation(s)
- Irene Göttgens
- Department of Primary and Community Care, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, Netherlands.
| | - Linda Modderkolk
- Department of Primary and Community Care, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, Netherlands
| | | | - Sirwan K L Darweesh
- Department of Neurology, Center of Expertise for Parkinson & Movement Disorders, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, Netherlands
| | - Bastiaan R Bloem
- Department of Neurology, Center of Expertise for Parkinson & Movement Disorders, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, Netherlands
| | - Sabine Oertelt-Prigione
- Department of Primary and Community Care, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, Netherlands; AG 10 Sex- and Gender-sensitive Medicine, Medical Faculty OWL, University of Bielefeld, Bielefeld, Germany.
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17
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Collett J, Brusco N, Cordell N, Cockroft A, Lawrie S, Coe S, Reed A, Dawes H. Lost employment potential and supporting people with Parkinson's to stay in work: insights from a Pan European cross-sectional survey. Disabil Rehabil 2023; 45:832-839. [PMID: 35249423 DOI: 10.1080/09638288.2022.2043460] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
PURPOSE To explore, in a European cohort of people living with Parkinson's (PD), issues affecting employment and economic consequences, considering age at diagnosis. MATERIALS AND METHODS A cross-sectional survey (European convenience sample). Inclusion criteria were ≥18 years, a PD diagnosis and in work when diagnosed. Data were collected online on demographics, employment status, occupation, and perceived health. For those no longer in paid work, time from diagnosis until loss of employment, reasons for leaving and enablers to stay in work were ascertained. RESULTS Between April and November 2019, n = 692 enrolled and n = 560 were eligible. Those who had lost paid work (n = 190, 34%) reported worse fatigue, sleep, and general health than those still in work (p < 0.05). Average annual income reduced from €26973.48 ± 12013.22 (year-1) to €14843.85 ± 16969.84 (year-10). Post-diagnosis lost employment potential was 20.1 (95% confidence interval (CI): 16.6-23.6) years at career establishment, 9.8 (95%CI: 8.9-10.7) years at mid working and 1.2 (95%CI: 0.6-1.6) years for those nearing retirement age. A greater proportion of individuals at career establishment age reported dexterity, eating, sleep, fatigue, and anxiety as factors for leaving work (p < 0.05). CONCLUSIONS This study confirms lost productivity after a PD diagnosis, especially in those with many years of potential employment ahead. The study also identified potential targets for interventions. Clinical trial registration: Clincaltrials.gov (NCT03905954).Implications for rehabilitationPeople with Parkinson's diagnosed at career establishment or at mid working age risk losing many years of potential employment.Most people with Parkinson's do not receive early intervention to support self-management of problems identified with leaving work early, such as fatigue.Adaptations to the work environment and more flexible working patterns were identified factors that may help people remain in work.
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Affiliation(s)
- Johnny Collett
- Faculty of Health and Life Sciences, Centre for Movement, Occupational and Rehabilitation Sciences, Oxford Brookes University, Oxford, UK
| | - Natasha Brusco
- School of Primary and Allied Health Care, Rehabilitation, Ageing and Independent Living (RAIL) Research Centre, Monash University, Frankston, Australia
| | - Nikki Cordell
- Faculty of Health and Life Sciences, Centre for Movement, Occupational and Rehabilitation Sciences, Oxford Brookes University, Oxford, UK
- Cordell Health Ltd, Wokingham, UK
| | - Annette Cockroft
- Faculty of Health and Life Sciences, Centre for Movement, Occupational and Rehabilitation Sciences, Oxford Brookes University, Oxford, UK
- Buckinghamshire Healthcare NHS Trust, Amersham, UK
| | - Sophie Lawrie
- Faculty of Health and Life Sciences, Centre for Movement, Occupational and Rehabilitation Sciences, Oxford Brookes University, Oxford, UK
| | - Shelly Coe
- Faculty of Health and Life Sciences, Centre for Movement, Occupational and Rehabilitation Sciences, Oxford Brookes University, Oxford, UK
- Faculty of Health and Life Sciences, Oxford Brookes Centre for Nutrition and Health, Oxford Brookes University, Oxford, UK
| | - Alex Reed
- European Parkinsons Therapy Centre, Brescia, Italy
| | - Helen Dawes
- Faculty of Health and Life Sciences, Centre for Movement, Occupational and Rehabilitation Sciences, Oxford Brookes University, Oxford, UK
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18
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Broadfoot CK, Lenell C, Kelm-Nelson CA, Ciucci MR. Effects of social isolation on 50-kHz ultrasonic vocalizations, affective state, cognition, and neurotransmitter concentrations in the ventral tegmental and locus coeruleus of adult rats. Behav Brain Res 2023; 437:114157. [PMID: 36241070 PMCID: PMC9829432 DOI: 10.1016/j.bbr.2022.114157] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 09/23/2022] [Accepted: 10/09/2022] [Indexed: 11/05/2022]
Abstract
Vocal communication, cognition, and affective state are key features of sustained health and wellness, and because vocalizations are often socially-motivated, social experience likely plays a role in these behaviors. The monoaminergic systems of the ventral tegmental area (VTA) and the locus coeruleus (LC) are associated with social and reward processing, vocalization production, and neurotransmitter changes in response to environmental stressors. The effect of social isolation on these complex behaviors and the underlying neural mechanisms is relatively unknown. To add to this body of literature, we randomized adult male Long-Evans rats to control (housed with a cagemate) or isolated (housed individually) conditions and assayed ultrasonic vocalizations, cognition (novel object recognition test), anxiety (elevated plus maze) and anhedonia (sucrose preference test) at 2, 4, 6, 8, and 10 months of age. At 10 months, VTA and LC samples were assayed for dopamine, norepinephrine, and serotonin using high performance liquid chromatography. We tested the hypotheses that isolation 1) diminishes vocalizations and cognition, 2) increases anxiety and depression, and 3) increases levels of dopamine, norepinephrine, and serotonin in the VTA and LC. Results showed isolation significantly reduced vocalization tonality (signal-to-noise ratio) and increased maximum frequency. There were no significant findings for cognition, anxiety, or anhedonia. Dopamine and serotonin and their respective metabolites were significantly increased in the VTA in isolated rats. These findings suggest chronic changes to social condition such as isolation affects vocalization production and levels of VTA neurotransmitters.
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Affiliation(s)
- Courtney K Broadfoot
- Department of Communication Sciences and Disorders, University of Wisconsin-Madison, 1975 Willow Drive, Madison, WI 53706, USA; Department of Surgery, Division of Otolaryngology-Head & Neck Surgery, University of Wisconsin-Madison, 600 Highland Avenue, Madison, WI 53792, USA.
| | - Charles Lenell
- Department of Audiology and Speech-Language Sciences, University of Northern Colorado, 1400 Gunter Hall, Greenly, CO 80639, USA
| | - Cynthia A Kelm-Nelson
- Department of Surgery, Division of Otolaryngology-Head & Neck Surgery, University of Wisconsin-Madison, 600 Highland Avenue, Madison, WI 53792, USA
| | - Michelle R Ciucci
- Department of Communication Sciences and Disorders, University of Wisconsin-Madison, 1975 Willow Drive, Madison, WI 53706, USA; Department of Surgery, Division of Otolaryngology-Head & Neck Surgery, University of Wisconsin-Madison, 600 Highland Avenue, Madison, WI 53792, USA; Neuroscience Training Program, University of Wisconsin-Madison, 9531 MIMR II, 1111 Highland Avenue, Madison, WI 53705, USA
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19
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Koszycki D, Taljaard M, Kogan C, Bradwejn J, Grimes D. Interpersonal Psychotherapy for Depression in Parkinson's Disease: A Feasibility Study. J Geriatr Psychiatry Neurol 2023; 36:52-62. [PMID: 35446178 PMCID: PMC9755694 DOI: 10.1177/08919887221090220] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Individuals living with Parkinson's disease (PD) experience interpersonal stressors that contribute to depressive risk. Interpersonal psychotherapy (IPT) emphasizes the bidirectional relationship between interpersonal stressors and mood may therefore be a suitable treatment for PD-depression. The primary aim of this study was to evaluate the feasibility of delivering 12 sessions of IPT to depressed PD patients and explore the need for modifications. A secondary aim was to obtain descriptive information about efficacy outcomes. The study used a pre-post design without a comparison group. Participants were 12 PD patients with a major depressive disorder. IPT was well accepted and tolerated by patients and required minimal modifications. Compliance with session attendance and completion of study questionnaires were excellent and treatment satisfaction was high. Depression scores declined from baseline to endpoint, with 7 patients meeting criteria for remission at endpoint. Findings are encouraging and a larger randomized controlled trial is currently underway to ascertain if IPT is an efficacious treatment for PD-depression.
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Affiliation(s)
- Diana Koszycki
- University of Ottawa, Ottawa, ON, Canada,Institut du savoir Montfort, Montfort Hospital, Ottawa, ON, Canada,University of Ottawa Brain and Mind Research Institute, Ottawa, ON, Canada,Diana Koszycki, PhD, University of Ottawa, 145 Jean-Jacques Lussier Ottawa, ON K1N 6N5, Canada.
| | - Monica Taljaard
- University of Ottawa, Ottawa, ON, Canada,Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Cary Kogan
- University of Ottawa, Ottawa, ON, Canada
| | - Jacques Bradwejn
- University of Ottawa, Ottawa, ON, Canada,Institut du savoir Montfort, Montfort Hospital, Ottawa, ON, Canada,Université de Montreal, QC, Canada
| | - David Grimes
- University of Ottawa, Ottawa, ON, Canada,University of Ottawa Brain and Mind Research Institute, Ottawa, ON, Canada,Ottawa Hospital Research Institute, Ottawa, ON, Canada
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20
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Perepezko K, Hinkle JT, Forbes EJ, Pontone GM, Mills KA, Gallo JJ. The impact of caregiving on quality of life in Parkinson's disease: A systematic review. Int J Geriatr Psychiatry 2023; 38:e5870. [PMID: 36703272 PMCID: PMC10214089 DOI: 10.1002/gps.5870] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 01/09/2023] [Indexed: 01/15/2023]
Abstract
OBJECTIVE Parkinson's disease (PD) is a progressive neurodegenerative disease that can reduce quality of life (QOL). Previous research has explored patient specific factors that influence QOL; but understanding external factors that may also affect patient QOL, such as caregiver characteristics, can provide additional intervention targets that may improve QOL for both the person with PD and their caregiver. METHODS We conducted a systematic review of existing literature on caregiver factors that are related to QOL for the person with PD. We developed a tailored search strategy in six databases and performed a screening procedure according to PRISMA guidelines. We synthesized findings from articles that met inclusion criteria using a narrative approach and identified themes categorizing caregiver factors associated with PD QOL. RESULTS We found 32 full-text articles that fulfilled the inclusion criteria and passed the quality appraisal. Seven themes were identified, including: (1) burden, (2) strain, (3) QOL and satisfaction, (4) demographic factors, (5) psychological factors, (6) relationship factors, and (7) caregiver input. CONCLUSIONS Our review presents critical insights into the role of the caregiver in the QOL of a person with PD. Findings reveal several targets for intervention to improve QOL in this population.
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Affiliation(s)
- Kate Perepezko
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | | | | | | | - Kelly A. Mills
- Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Joseph J. Gallo
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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21
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Chen YR, Tan CH, Su HC, Chien CY, Sung PS, Lin TY, Lee TL, Yu RL. Investigating the interaction between neuropsychiatry features and daily activities on social function in patients with Parkinson's disease with mild cognitive impairment. BJPsych Open 2022; 8:e205. [PMID: 36426564 PMCID: PMC9707510 DOI: 10.1192/bjo.2022.611] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Social functioning is crucial for daily living and is an essential indicator of dementia in patients with Parkinson's disease. The pattern of social functioning in patients with Parkinson's disease without dementia (i.e. those who are cognitively intact or have mild cognitive impairment (PD-MCI)) and its determinants are unclear. AIMS In exploring the heterogeneity of social functioning among patients with Parkinson's disease-associated dementia, we determined the optimal cut-off score of the Parkinson's Disease Social Functioning Scale (PDSFS) for patients with PD-MCI, and the variables influencing patients' social functioning. METHOD A total of 302 participants underwent the Mini-Mental State Examination (MMSE) and PDSFS; 120 patients with Parkinson's disease completed the measurements (MMSE, Activities of Daily Living Scale and Neuropsychiatric Inventory). Group comparisons, receiver operating characteristic curves, Spearman correlation and multiple and hierarchical regression analyses were conducted. RESULTS The PD-MCI group scored the lowest on the PDSFS (F = 10.10, P < 0.001). The PDSFS cut-off score was 53 (area under the curve 0.700, sensitivity 0.800, specificity 0.534). The MMSE (β = 0.293, P = 0.002), Activities of Daily Living Scale (β = 0.189, P = 0.028) and Neuropsychiatric Inventory (β = -0.216, P = 0.005) scores predicted the PDSFS score. Further, there was an interaction effect between the Activities of Daily Living Scale and Neuropsychiatric Inventory scores on the PDSFS score (β = 0.305, P < 0.001). CONCLUSIONS We determined a PDSFS cut-off score for detecting PD-MCI and found that patients with PD-MCI have social dysfunction. Future research should focus on the effects of neuropsychiatry symptoms and activities of daily living on social functioning, and tailor the intervention programme for patients with Parkinson's disease.
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Affiliation(s)
- Yi-Ru Chen
- Institute of Behavioral Medicine, College of Medicine, National Cheng Kung University, Taiwan
| | - Chun-Hsiang Tan
- Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Taiwan; and Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Taiwan
| | - Hui-Chen Su
- Department of Neurology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Taiwan
| | - Chung-Yao Chien
- Department of Neurology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Taiwan
| | - Pi-Shan Sung
- Department of Neurology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Taiwan
| | - Tien-Yu Lin
- Department of Neurology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Taiwan
| | - Tsung-Lin Lee
- Department of Neurology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Taiwan
| | - Rwei-Ling Yu
- Institute of Behavioral Medicine, College of Medicine, National Cheng Kung University, Taiwan
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22
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Yu RL, Wu RM. Mild cognitive impairment in patients with Parkinson’s disease: An updated mini-review and future outlook. Front Aging Neurosci 2022; 14:943438. [PMID: 36147702 PMCID: PMC9485585 DOI: 10.3389/fnagi.2022.943438] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 08/15/2022] [Indexed: 12/04/2022] Open
Abstract
Mild cognitive impairment (MCI) is one of the common non-motor symptoms in patients with Parkinson’s disease (PD). MCI is the transition stage between normal aging and full-blown dementia and is also a powerful predictor of dementia. Although the concept of MCI has been used to describe some of the PD symptoms for many years, there is a lack of consistent diagnostic criteria. Moreover, because of the diverse patterns of the cognitive functions, each cognitive impairment will have a different progression. In this review, we overviewed the diagnostic criteria for PD-MCI, primarily focused on the heterogeneity of PD-MCI patients’ cognitive function, including various types of cognitive functions and their progression rates. A review of this topic is expected to be beneficial for clinical diagnosis, early intervention, and treatment. In addition, we also discussed the unmet needs and future vision in this field.
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Affiliation(s)
- Rwei-Ling Yu
- College of Medicine, Institute of Behavioral Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Ruey-Meei Wu
- Department of Neurology, College of Medicine, National Taiwan University Hospital, National Taiwan University, Taipei, Taiwan
- *Correspondence: Ruey-Meei Wu,
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Interian A, Mann SL, Mavandadi S, St Hill LM, Kashan R, Rodriguez KM, Dobkin RD. Criticism in the Parkinson's Caregiving Relationship: A Key Target for Intervention. J Geriatr Psychiatry Neurol 2022; 35:671-679. [PMID: 34607483 PMCID: PMC11070948 DOI: 10.1177/08919887211049119] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Caregiver distress is prevalent in Parkinson's disease (PD) and predictive of negative health outcomes for both people with PD and caregivers. To identify future intervention targets, it is important to better elucidate the specific processes, such as criticism, that perpetuate burden. OBJECTIVE Evaluate the frequency and impact of criticism and reactivity to criticism in PD caregiving dyads. METHODS Eighty-three people with PD and their caregivers independently completed measures of criticism and physical and emotional health. RESULTS Criticism in the caregiving relationship was reported by 71.1% (n = 59) of people with PD and 80.7% (n = 67) of caregivers. Both perceived criticism and emotional reactivity to criticism were significant predictors of caregiver distress, adjusting for PD motor and non-motor symptom severity. In contrast, criticism was not related to PD depression. CONCLUSION Criticism in the PD caregiving relationship is a clear target for psychotherapeutic intervention and may improve caregiver health and quality of life.
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Affiliation(s)
| | | | | | | | - Rachel Kashan
- Department of Psychiatry, Rutgers Robert Wood Johnson Medical School, Piscataway, NJ, USA. Mann is now with Bellevue Hospital, New York, NY, USA
| | | | - Roseanne D Dobkin
- Department of Psychiatry, Rutgers Robert Wood Johnson Medical School, Piscataway, NJ, USA. Mann is now with Bellevue Hospital, New York, NY, USA
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24
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D'Iorio A, Baiano C, Maraucci G, Vitale C, Amboni M, Santangelo G. A longitudinal study on the effects of COVID-19 pandemic on non-motor symptoms in Parkinson’s disease. Neurol Sci 2022; 43:4605-4609. [PMID: 35538300 PMCID: PMC9088717 DOI: 10.1007/s10072-022-06112-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 04/29/2022] [Indexed: 11/24/2022]
Abstract
Introduction The COVID-19 pandemic led to psychological consequences on people’s mental health, representing a condition of increased vulnerability for the weakest sections of population, including elderly patients with Parkinson’s disease (PD). This longitudinal study aimed at exploring the impact of the most frequent non-motor symptoms and their contribute on health-related quality of life of PD patients after the COVID-19 outbreak, in comparison with the pre-pandemic status. Methods Forty-two non-demented PD patients underwent a first assessment between December 2018 and January 2020 (T0). Then, between March and May 2021 (T1), they were contacted again and asked to complete the second assessment. Levels of global functioning, several non-motor symptoms (i.e. depression, apathy, anxiety, anhedonia) and health-related quality of life were investigated. Results Results of the the paired Wilcoxon signed-rank test showed that at T1, PD patients scored lower on the emotional subscale of the DAS, Z = − 2.49; p = 0.013; Cohen dz = 0.691. Higher scores of the TEPS total score, Z = − 2.38; p = 0.025; Cohen dz = 0.621, and LEDD, Z = − 2.63; p = 0.008; Cohen dz = 0.731, were also reported at T1. Conclusion The present study suggested that self-isolation at home might lead to a reduction of apathy and anhedonia in PD patients due to the increase in social support provided by families during COVID-19 restrictions. This evidence brings out the need of a consistent and persistent social support which might be represented by caregivers or/and social assistive robotics.
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Affiliation(s)
- Alfonsina D'Iorio
- Department of Psychology, University of Campania "Luigi Vanvitelli", Caserta, Italy
| | - Chiara Baiano
- Department of Psychology, University of Campania "Luigi Vanvitelli", Caserta, Italy
| | - Giovanna Maraucci
- Department of Psychology, University of Campania "Luigi Vanvitelli", Caserta, Italy
| | - Carmine Vitale
- Department of Motor Sciences and Wellness, University "Parthenope", Naples, Italy
- Institute of Diagnosis and Care (IDC), Hermitage-Capodimonte, Naples, Italy
| | - Marianna Amboni
- Institute of Diagnosis and Care (IDC), Hermitage-Capodimonte, Naples, Italy
- Department of Medicine, Center for Neurodegenerative Diseases (CEMAND), University of Salerno, Salerno, Italy
| | - Gabriella Santangelo
- Department of Psychology, University of Campania "Luigi Vanvitelli", Caserta, Italy.
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25
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Feenstra W, Nonnekes J, Rahimi T, Reinders-Messelink HA, Dijkstra PU, Bloem BR. Dance classes improve self-esteem and quality of life in persons with Parkinson's disease. J Neurol 2022; 269:5843-5847. [PMID: 35763112 DOI: 10.1007/s00415-022-11206-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 04/29/2022] [Accepted: 05/29/2022] [Indexed: 10/17/2022]
Abstract
INTRODUCTION Dance can reduce motor symptoms in persons with Parkinson's disease (PD). However, the effect on psychosocial wellbeing, including self-esteem and quality of life is less clear. METHODS Forty-nine persons with PD (Hoehn and Yahr stage 1-4) participated in weekly dance classes for a consecutive period of 22 weeks, 36 participants completed the classes. Two baseline measurements (T1a and T1b) were performed during a 2-week control period prior to the dance classes. Post-measurements (T2) were performed immediately after 22 weeks of dance classes. Primary outcome was self-esteem as measured with the Rosenberg Self-Esteem Score. RESULTS Self-esteem scores were stable across the two baseline measurements and improved significantly after the dance classes (1.5 points improvement between T1b and T2, 95% CI 0.3, 2.7; p = 0.012). Additionally, quality of life as measured with the Parkinson's Disease Questionnaire 39 improved significantly (3.4 points reduction between T1b and T2, 95%CI - 5.7, - 1.2; p = 0.003) as did motor symptoms as measured with the Movement Disorders Society-Unified Parkinson's Disease Rating Scale-part III (6.2 points reduction between T1b and T2, 95%CI - 10.1, - 2.4; p = 0.002). Balance confidence as measured with the Activities-Specific Balance Confidence Scale did not change. DISCUSSION AND CONCLUSIONS Dance classes seem to improve self-esteem, quality of life and motor symptoms in persons with PD. These effects should be investigated further in a randomized clinical trial. CLINICAL MESSAGE Dance classes may be a valuable complementary treatment option in people with PD to improve not only motor symptoms, but also self-esteem and quality of life.
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Affiliation(s)
- Wya Feenstra
- Rehabilitation Center 'Revalidatie Friesland', Beetsterzwaag, The Netherlands.
| | - Jorik Nonnekes
- Department of Neurology, Centre of Expertise for Parkinson and Movement Disorders, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, The Netherlands.,Department of Rehabilitation, Sint Maartenskliniek, Ubbergen, The Netherlands
| | - Tahmina Rahimi
- Department of Neurology, Centre of Expertise for Parkinson and Movement Disorders, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, The Netherlands.,Utrecht University, Utrecht, The Netherlands
| | - Heleen A Reinders-Messelink
- Rehabilitation Center 'Revalidatie Friesland', Beetsterzwaag, The Netherlands.,Center for Rehabilitation, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Pieter U Dijkstra
- Center for Rehabilitation, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.,Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Bas R Bloem
- Department of Neurology, Centre of Expertise for Parkinson and Movement Disorders, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, The Netherlands
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Colombo B, Rigby A, Gnerre M, Biassoni F. The Effects of a Dance and Music-Based Intervention on Parkinson's Patients' Well-Being: An Interview Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127519. [PMID: 35742768 PMCID: PMC9224214 DOI: 10.3390/ijerph19127519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 06/16/2022] [Accepted: 06/17/2022] [Indexed: 11/29/2022]
Abstract
Previous research has shown the positive effects of music and dance-based interventions on the physical and psychosocial symptoms of Parkinson’s disease (PD). The aims of this study were: (1) to investigate how PD patients subjectively perceive the emotional, cognitive, and social benefits of a music- and dance-based intervention; (2) to apply an innovative methodology for an interview analysis combining findings from a linguistic text with an analytic approach and conducted with the software LIWC and from the content analysis performed by human coders. Extensive, open-ended interviews were conducted with 13 patients with PD who had participated in a dance and music program. The interviews were analyzed using both human coders and the computer-based approach. The results show that emotional and social aspects are considered the most frequent perceived benefits of the dance program. The data confirm the positive impact of dance- and music-based programs on promoting participants’ emotional and social well-being. A combined approach to text analysis appears to be a promising way to achieve more in-depth insights into patients’ subjective perceptions.
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Affiliation(s)
- Barbara Colombo
- Behavioral Neuroscience Lab, Champlain College, Burlington, VT 05401, USA;
- Correspondence:
| | - Alison Rigby
- Behavioral Neuroscience Lab, Champlain College, Burlington, VT 05401, USA;
| | - Martina Gnerre
- Università Cattolica del Sacro Cuore, 20123 Milano, Italy; (M.G.); (F.B.)
| | - Federica Biassoni
- Università Cattolica del Sacro Cuore, 20123 Milano, Italy; (M.G.); (F.B.)
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27
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Yu YW, Tan CH, Su HC, Chien CY, Sung PS, Lin TY, Lee TL, Yu RL. A New Instrument Combines Cognitive and Social Functioning Items for Detecting Mild Cognitive Impairment and Dementia in Parkinson’s Disease. Front Aging Neurosci 2022; 14:913958. [PMID: 35783135 PMCID: PMC9243636 DOI: 10.3389/fnagi.2022.913958] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 05/16/2022] [Indexed: 11/22/2022] Open
Abstract
Background The commonly used screening tests for Parkinson’s disease (PD) are the Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination (MMSE), both of which only focus on cognitive function. A composite assessment that considers both cognitive and social dysfunction in PD would be helpful in detecting mild cognitive impairment (MCI) and PD dementia (PDD). Objective We aimed to simplify the commonly used tools and combine cognitive and social functioning tests to detect early MCI and PDD. Materials and Methods A total of 166 participants (84 PD patients and 82 healthy) were recruited who completed the MMSE, MoCA, PD social functioning scale (PDSFS), clock drawing test, activities of daily living, comprehensive neuropsychological assessment (e.g., executive, attention, language, memory, and visuospatial functions), and movement disorder society (MDS)-unified PD rating scale. According to the MDS diagnostic criteria, the patients were grouped into PD-nonMCI, PD-MCI, or PDD. Results To detect PD-MCI, the optimal cut-off scores for the simplified MoCA and the combined test were 9 and 35. The discrimination values measured by the area under the receiver operating characteristic curve (AUC) of the two tests were 0.767 (p < 0.001) and 0.790 (p < 0.001). When the simplified MoCA was 7 or the combined test 30, the patients would be classified as having PDD. The AUCs of the two tests were 0.846 (p < 0.001) and 0.794 (p = 0.003). Conclusion We suggest considering both cognitive and social functions when detecting PD-MCI and PDD.
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Affiliation(s)
- Ya-Wen Yu
- Institute of Behavioral Medicine, College of Medicine, National Cheng Kung University, Tainan City, Taiwan
| | - Chun-Hsiang Tan
- Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung City, Taiwan
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan
| | - Hui-Chen Su
- Department of Neurology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan City, Taiwan
| | - Chung-Yao Chien
- Department of Neurology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan City, Taiwan
| | - Pi-Shan Sung
- Department of Neurology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan City, Taiwan
| | - Tien-Yu Lin
- Department of Neurology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan City, Taiwan
| | - Tsung-Lin Lee
- Department of Neurology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan City, Taiwan
| | - Rwei-Ling Yu
- Institute of Behavioral Medicine, College of Medicine, National Cheng Kung University, Tainan City, Taiwan
- *Correspondence: Rwei-Ling Yu,
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Zapf AC, Folkerts AK, Kahler L, Schnitzler A, Reker P, Barbe MT, Florin E, Kalbe E. No Higher Risk-Seeking Tendencies or Altered Self-Estimation in a Social Decision-Making Task in Patients with Parkinson's Disease. JOURNAL OF PARKINSON'S DISEASE 2022; 12:1045-1057. [PMID: 35180130 DOI: 10.3233/jpd-212960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
BACKGROUND Parkinson's disease (PD) has been associated with a tendency towards more risky decisions. However, the commonly used paradigms typically neglect the social context. OBJECTIVE Here, we investigated social decision-making and self-estimation in a competitive experimental task. METHODS A computerized experimental setting was used in which 86 PD patients (age = 66.5 [50-79], 62.8% male, H&Y = 2 [1.5-3]) and 44 healthy controls (HC; age = 67 [54-79], 54.4% male) in groups of four performed mathematical addition tasks in which they were asked to calculate as many sums as possible in five minutes. Participants had to choose their preferred compensation scheme ("piece rate" versus "tournament") and retrospectively rank their performance in comparison to the suspected performance of the others. A comprehensive neuropsychological test battery was also conducted. RESULTS No significant difference was found in overall social decision-making and self-estimation between PD patients and HC. However, for those individuals who made inadequate decisions, PD patients engaged in significantly more risk-averse and HC in more risky decisions. Concerning those inadequate decisions, the PD patients made more extreme decisions (severity of social decision-making) in both directions (risk-averse, risk-seeking). CONCLUSION Our data indicate that social decision-making behavior and self-estimation are largely intact in PD patients with mild to moderate disease stages and intact global cognition, executive functions, and social cognition. Future studies with more heterogeneous PD samples regarding their neuropsychological profile will have to examine at which state social decision-making may be affected and by which factors this behavior might be influenced.
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Affiliation(s)
- Alexandra C Zapf
- Department of Medical Psychology | Neuropsychology and Gender Studies & Center for Neuropsychological Diagnostics and Intervention (CeNDI), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Ann-Kristin Folkerts
- Department of Medical Psychology | Neuropsychology and Gender Studies & Center for Neuropsychological Diagnostics and Intervention (CeNDI), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Larissa Kahler
- Department of Medical Psychology | Neuropsychology and Gender Studies & Center for Neuropsychological Diagnostics and Intervention (CeNDI), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Alfons Schnitzler
- Institute of Clinical Neuroscience and Medical Psychology & Department of Neurology - Center for Movement Disorders and Neuromodulation, Medical Faculty, Heinrich Heine University of Duesseldorf, Duesseldorf, Germany
| | - Paul Reker
- Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Michael T Barbe
- Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Esther Florin
- Institute of Clinical Neuroscience and Medical Psychology & Department of Neurology - Center for Movement Disorders and Neuromodulation, Medical Faculty, Heinrich Heine University of Duesseldorf, Duesseldorf, Germany
| | - Elke Kalbe
- Department of Medical Psychology | Neuropsychology and Gender Studies & Center for Neuropsychological Diagnostics and Intervention (CeNDI), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
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29
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Kay KR, Uc EY. Real-life consequences of cognitive dysfunction in Parkinson's disease. PROGRESS IN BRAIN RESEARCH 2022; 269:113-136. [DOI: 10.1016/bs.pbr.2022.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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30
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Social isolation, loneliness and mental health sequelae of the Covid-19 pandemic in Parkinson's disease. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2022; 165:197-227. [PMID: 36208901 PMCID: PMC9034749 DOI: 10.1016/bs.irn.2022.03.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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31
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Hermanowicz N, Ospina MC, Torres-Yaghi Y, Gould S, Papesh K, Rivera JA, Miller S, Jones S, Musick K, May D. Impact of Isolation During the COVID-19 Pandemic on the Patient Burden of Parkinson's Disease: A PMD Alliance Survey. Neuropsychiatr Dis Treat 2022; 18:633-643. [PMID: 35355505 PMCID: PMC8958201 DOI: 10.2147/ndt.s351691] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 02/22/2022] [Indexed: 01/10/2023] Open
Abstract
PURPOSE As the COVID-19 pandemic resulted in social restrictions around the globe, this cross-sectional survey aimed to assess the impact of social isolation on self- or proxy-reported symptoms of Parkinson's disease (PD) during the pandemic. PATIENTS AND METHODS The survey was distributed among 7109 subscribers of the Parkinson and Movement Disorders Alliance (PMD Alliance) News and Information list and was open only to people with PD (PwP) and care partners (CP, defined as main caregivers of PwP and serving as proxy respondents). No attempt was made to identify PwP and CP pairs. The survey was distributed online using Survey Monkey between 01/06/2021 and 02/27/2021. Respondents were grouped by level of social support from outside of their household during the pandemic (decreased or maintained [ie, the same as pre-pandemic or increased]). RESULTS Of 7109 invited participants, 718 responded to the survey (response rate 10.1%). PwP (self-reports) accounted for 70.6% of respondents and CP (proxy reports) for 29.4%. Decreased social support from outside of the household during the COVID-19 pandemic (58.5% of all responses) was significantly associated with increases in sadness/depression and anxiety, compared with maintained levels of social support (p < 0.0001 for both comparisons). It was also associated with increased burden of several non-motor (decline in memory, problem solving, or communication, p = 0.0009; new or worsening confusion, p < 0.0001; new or worsening delusions, p = 0.018) and motor PD symptoms. CONCLUSION Decline in social support from outside of the household during the COVID-19 pandemic showed a statistically significant and negative association with the burden of mood and non-motor symptoms of PD. These results call for increased vigilance towards non-motor symptoms in PwP experiencing social isolation and highlight the need for stronger provider focus on encouraging PwP and their CPs to build and maintain social connections and engagements.
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Affiliation(s)
| | | | | | - Sherrie Gould
- Scripps Clinic Movement Disorder Center, La Jolla, CA, USA
| | - Kelly Papesh
- Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas, NV, USA
| | - Jason A Rivera
- Parkinson and Movement Disorder Alliance (PMD Alliance), Tucson, AZ, USA
| | - Susan Miller
- Parkinson and Movement Disorder Alliance (PMD Alliance), Tucson, AZ, USA
| | - Sarah Jones
- Parkinson and Movement Disorder Alliance (PMD Alliance), Tucson, AZ, USA
| | | | - Damian May
- ACADIA Pharmaceuticals Inc, San Diego, CA, USA
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Thieken F, van Munster M. Deriving Implications for Care Delivery in Parkinson's Disease by Co-Diagnosing Caregivers as Invisible Patients. Brain Sci 2021; 11:brainsci11121629. [PMID: 34942931 PMCID: PMC8699371 DOI: 10.3390/brainsci11121629] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 11/29/2021] [Accepted: 12/07/2021] [Indexed: 11/30/2022] Open
Abstract
For persons with Parkinson’s disease, the loss of autonomy in daily life leads to a high level of dependency on relatives’ support. Such dependency strongly correlates with high levels of perceived stress and psychosocial burden in informal caregivers. Global developments, such as demographic change and the associated thinning infrastructure in rural areas cause a continuously growing need for medical and nursing care. However, this need is not being adequately met. The resulting care gap is being made up by unpaid or underpaid work of informal caregivers. The double burden of care work and gainful employment creates enormous health-related impairments of the informal caregivers, so that they eventually become invisible patients themselves. Expectedly, those invisible patients do not receive the best care, leading to a decrease in quality of life and, in the end, to worse care for PD patients. Suggested solutions to relieve relatives, such as moving the person affected by Parkinson’s to a nursing home, often do not meet the wishes of patients and informal caregivers, nor does it appear as a structural solution in the light of demographic change against an economic background. Rather, it requires the development, implementation and evaluation of new, holistic approaches to care that make invisible patients visible.
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Affiliation(s)
- Franziska Thieken
- Department of Neurology, University Hospital of Marburg, Baldingerstraße, 35043 Marburg, Germany;
- Correspondence: ; Tel.: +49-6421-58-64855
| | - Marlena van Munster
- Faculty of Medicine, Philipps-Universität Marburg, Biegenstraße 10, 35037 Marburg, Germany
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Gerritzen EV, Lee AR, McDermott O, Coulson N, Orrell M. Online peer support for people with Parkinson’s Disease: a narrative synthesis systematic review (Preprint). JMIR Aging 2021; 5:e35425. [PMID: 35896025 PMCID: PMC9377481 DOI: 10.2196/35425] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Revised: 03/27/2022] [Accepted: 03/31/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- Esther Vera Gerritzen
- Institute of Mental Health, Mental Health and Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Abigail Rebecca Lee
- Institute of Mental Health, Mental Health and Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Orii McDermott
- Institute of Mental Health, Mental Health and Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Neil Coulson
- Population and Lifespan Health, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Martin Orrell
- Institute of Mental Health, Mental Health and Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, United Kingdom
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Rosengren L, Forsberg A, Brogårdh C, Lexell J. Social Belonging as the Main Concern for Achieving Life Satisfaction When Adapting to Parkinson's Disease. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:8653. [PMID: 34444401 PMCID: PMC8391246 DOI: 10.3390/ijerph18168653] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 08/13/2021] [Accepted: 08/13/2021] [Indexed: 01/31/2023]
Abstract
Parkinson's disease (PD) is a complex, progressive neurological condition that impacts daily life and reduces life satisfaction (LS). To achieve and maintain high LS, persons with PD (PwPD) must go through a process of change to adapt to their new life situation. However, our knowledge about this process is very limited. The aim of this study was to investigate the process of change, and the main concern in this process, in PwPD. To study the transitional experience of PwPD, an inductive qualitative approach, using Grounded Theory (GT), was employed. Thirteen participants (9 women, 3 men and 1 non-binary), with a mean age of 54 years (range from 47-62 years), participated in in-depth interviews. Data showed that social belonging is the main concern in the process of change for PwPD. In this process of change, they use strategies to comprehend, accept, adapt, and balance in their strive for social belonging, which in turn can enhance LS. Health care professionals can use this model with an interdisciplinary approach to support PwPD through a successful process of change to achieve social belonging, and thereby achieving and maintaining LS.
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Affiliation(s)
- Lina Rosengren
- Department of Health Sciences, Lund University, S-221 00 Lund, Sweden; (A.F.); (C.B.); (J.L.)
- Department of Neurology, Rehabilitation Medicine, Memory Disorders and Geriatrics, Skåne University Hospital, S-221 85 Lund, Sweden
| | - Anna Forsberg
- Department of Health Sciences, Lund University, S-221 00 Lund, Sweden; (A.F.); (C.B.); (J.L.)
- Department of Thoracic Surgery, Skåne University Hospital, S-222 85 Lund, Sweden
| | - Christina Brogårdh
- Department of Health Sciences, Lund University, S-221 00 Lund, Sweden; (A.F.); (C.B.); (J.L.)
- Department of Neurology, Rehabilitation Medicine, Memory Disorders and Geriatrics, Skåne University Hospital, S-221 85 Lund, Sweden
| | - Jan Lexell
- Department of Health Sciences, Lund University, S-221 00 Lund, Sweden; (A.F.); (C.B.); (J.L.)
- Department of Neurology, Rehabilitation Medicine, Memory Disorders and Geriatrics, Skåne University Hospital, S-221 85 Lund, Sweden
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Basirat A, Moreau C, Knutsen D. Parkinson's disease impacts feedback production during verbal communication. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2021; 56:826-840. [PMID: 34227719 DOI: 10.1111/1460-6984.12630] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 04/20/2021] [Accepted: 04/21/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Parkinson's disease (PD) leads to changes in verbal communications. The focus of most studies to date has been on speech impairment, which is specifically referred to as dysarthria. Although these studies are crucial to understanding the impact of PD on verbal communication, they do not focus on the features of dialogues between people with PD (PwPD) and other people in communicative contexts. AIMS To investigate whether PwPD produce less feedback than typical people during dialogue, thus potentially making it more difficult for them to reach mutual comprehension (i.e., common ground) with their conversational partner. METHODS & PROCEDURES A matching task experiment was conducted during which an experimenter described abstract pictures to a participant, who was either a PwPD or a typical participant, so that he or she could organize these pictures in a grid. The participants could produce as much feedback as they liked. OUTCOMES & RESULTS PwPD were less likely to produce feedback than typical participants. This effect was mainly driven by two specific types of feedback: acknowledgment tokens and hesitations. CONCLUSIONS & IMPLICATIONS The results suggest that PD impacts feedback production. This could decrease the communicative abilities of PwPD in interactive contexts by affecting grounding, that is, the ability to build common ground with others. This paper is one of the first to specifically document the production of feedback markers in PwPD. Future studies should examine the extent to which our results, which were obtained in a controlled dialogue task, may be generalized to daily-life conversions. From a clinical perspective, our study points to the necessity of assessing feedback production, and more generally abilities related to common ground construction and use, during PD progression. WHAT IS ALREADY KNOWN ON THE SUBJECT A few studies to date have analyzed conversational interactions between people with Parkinson's disease (PwPD) and others. The main focus is usually on potential difficulties of PwPD and their partners during the interaction and the strategies adopted to "repair" these problems. Another important feature of any interaction is the production of feedback. Feedback production plays a key role in building and using common ground to ensure mutual comprehension between interlocutors. The impact of Parkinson's disease on feedback production has received little attention in the literature to date. WHAT THIS STUDY ADDS The purpose of this study was to compare feedback production in a dialogue task (i.e., goal-oriented interaction) in PwPD versus typical controls. Our results revealed that PwPD produced less feedback for their dialogue partners than did typical participants. This effect was mainly driven by two specific types of feedback: acknowledgment tokens and hesitations. This paper is one of the firsts to specifically document the production of feedback markers in PwPD and to illustrate that PwPD and their dialogue partners may require more time and effort to establish common ground. CLINICAL IMPLICATIONS OF THIS STUDY Our findings suggest that an appropriate evaluation of feedback production by speech and language therapists, as well the management of potential deficits, would be beneficial. More broadly, we believe that the evaluation and management of PwPD should take into account the theoretical framework used in this study, in particular the role of common ground in communication.
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Affiliation(s)
- Anahita Basirat
- University of Lille, CNRS, UMR 9193-SCALab-Sciences Cognitives et Sciences Affectives, Lille, France
| | - Caroline Moreau
- Expert Center for Parkinson's Disease, CHU Lille, Inserm UMR 1171-2, University of Lille, Lille, France
- University of Lille, Inserm, CHU Lille, U1171-2-LilNCog-Lille Neuroscience & Cognition, Lille, France
| | - Dominique Knutsen
- University of Lille, CNRS, UMR 9193-SCALab-Sciences Cognitives et Sciences Affectives, Lille, France
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Macchi ZA, Ayele R, Dini M, Lamira J, Katz M, Pantilat SZ, Jones J, Kluger BM. Lessons from the COVID-19 pandemic for improving outpatient neuropalliative care: A qualitative study of patient and caregiver perspectives. Palliat Med 2021; 35:1258-1266. [PMID: 34006157 PMCID: PMC9447864 DOI: 10.1177/02692163211017383] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND COVID-19 has impacted persons with serious illness, including those with chronic, neurodegenerative conditions. While there are several reports on COVID-19's impact on inpatient palliative care, literature is limited about the impact on outpatient care which may be more relevant for these patients. AIM To generate a person-centered description of the impact of COVID-19 from the perspectives of patients living with neurodegenerative disease and caregivers to improve outpatient palliative care delivery. DESIGN This qualitative study used rapid analysis via matrix design to identify emergent themes related to participant perspectives on the challenges of COVID-19. Data sources included semi-structured interviews, open-ended survey responses, medical record documentation and participant-researcher communications. SETTING/PARTICIPANTS Data was collected from 108 patients with Parkinson's disease, Alzheimer's disease or related disorders and 90 caregivers enrolled in a multicenter, clinical trial of community-based, outpatient palliative care between March 20, 2020 and August 8, 2020 (NCT03076671). RESULTS Four main themes emerged: (1) disruptions to delivery of healthcare and other supportive services; (2) increased symptomatic and psychosocial needs; (3) increased caregiver burden; (4) limitations of telecommunications when compared to in-person contact. We observed that these themes interacted and intersected. CONCLUSIONS Patients and caregivers have unmet care needs because of the pandemic, exacerbated by social isolation. While telemedicine has helped improve access to healthcare, patients and caregivers perceive clear limitations compared to in-person services. Changes in society and healthcare delivery in response to COVID-19 highlight ongoing and novel gaps that must be addressed to optimize future outpatient palliative care for neurologic illness.
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Affiliation(s)
- Zachary A Macchi
- Department of Neurology, University of Colorado Anschutz, Aurora, CO, USA.,Department of Internal Medicine, University of Colorado Anschutz, Aurora, CO, USA
| | - Roman Ayele
- College of Nursing, University of Colorado Anschutz, Aurora, CO, USA
| | - Megan Dini
- Department of Neurology, University of Colorado Anschutz, Aurora, CO, USA
| | - Jensine Lamira
- Department of Cell & Developmental Biology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Maya Katz
- Department of Neurology, University of California San Francisco, San Francisco, CA, USA
| | - Steven Z Pantilat
- Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Jacqueline Jones
- College of Nursing, University of Colorado Anschutz, Aurora, CO, USA
| | - Benzi M Kluger
- Departments of Neurology and Medicine, University of Rochester Medical Center, Rochester, NY, USA
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Moonen AJH, Mulders AEP, Defebvre L, Duits A, Flinois B, Köhler S, Kuijf ML, Leterme AC, Servant D, de Vugt M, Dujardin K, Leentjens AFG. Cognitive Behavioral Therapy for Anxiety in Parkinson's Disease: A Randomized Controlled Trial. Mov Disord 2021; 36:2539-2548. [PMID: 33617699 PMCID: PMC9290129 DOI: 10.1002/mds.28533] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Revised: 01/13/2021] [Accepted: 01/22/2021] [Indexed: 12/14/2022] Open
Abstract
Background Anxiety disorders are among the most prevalent and disabling neuropsychiatric syndromes in patients with Parkinsonʼs disease (PD), but no randomized controlled treatment trials of anxiety have been published to date. Objective The aim of this study was to assess the effectiveness of cognitive behavioral therapy (CBT) in the treatment of anxiety in patients with PD. Methods Forty‐eight patients with PD with anxiety were randomized 1:1 between CBT and clinical monitoring only (CMO). The CBT program was developed to specifically address anxiety symptoms in PD and consisted of 10 weekly sessions. Assessments were conducted by blinded assessors at baseline, at the end of the intervention, after 3 months, and after 6 months (CBT group only). Main outcome measures were the Hamilton Anxiety Rating Scale (HARS) and the Parkinson Anxiety Scale (PAS). Results Both the CBT and CMO groups showed clinically relevant improvement. Although there was no between‐group difference in outcome on the Hamilton Anxiety Rating Scale (6.7‐point reduction in the CBT group versus 3.9‐point reduction in the CMO group; P = 0.15), there was both a statistically significant and a clinically relevant between‐group difference on the total PAS in favor of CBT (9.9‐point reduction in the CBT group versus 5.2‐point reduction in the CMO group; P = 0.012), which was due to improvement on the PAS subscales for episodic (situational) anxiety and avoidance behavior. This greater improvement was maintained at 3‐ and 6‐month follow‐ups. Conclusion CBT is an effective treatment for anxiety in patients with PD and reduces situational and social anxiety, as well as avoidance behavior. © 2021 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society
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Affiliation(s)
- Anja J H Moonen
- Department of Psychiatry and Neuropsychology, Maastricht University Medical Centre, Maastricht, the Netherlands.,Research School of Mental Health and Neuroscience (Mhens), Maastricht University, Maastricht, the Netherlands
| | - Anne E P Mulders
- Department of Psychiatry and Neuropsychology, Maastricht University Medical Centre, Maastricht, the Netherlands.,Research School of Mental Health and Neuroscience (Mhens), Maastricht University, Maastricht, the Netherlands
| | - Luc Defebvre
- Neurology and Movement Disorders Department, Centre Hospitalier Universitaire, Lille, France
| | - Annelien Duits
- Department of Psychiatry and Neuropsychology, Maastricht University Medical Centre, Maastricht, the Netherlands.,Research School of Mental Health and Neuroscience (Mhens), Maastricht University, Maastricht, the Netherlands
| | - Bérengère Flinois
- Neurology and Movement Disorders Department, Centre Hospitalier Universitaire, Lille, France
| | - Sebastian Köhler
- Research School of Mental Health and Neuroscience (Mhens), Maastricht University, Maastricht, the Netherlands
| | - Mark L Kuijf
- Research School of Mental Health and Neuroscience (Mhens), Maastricht University, Maastricht, the Netherlands.,Department of Neurology, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Anne-Claire Leterme
- Neurology and Movement Disorders Department, Centre Hospitalier Universitaire, Lille, France
| | - Dominique Servant
- Neurology and Movement Disorders Department, Centre Hospitalier Universitaire, Lille, France
| | - Marjolein de Vugt
- Department of Psychiatry and Neuropsychology, Maastricht University Medical Centre, Maastricht, the Netherlands.,Research School of Mental Health and Neuroscience (Mhens), Maastricht University, Maastricht, the Netherlands
| | - Kathy Dujardin
- Neurology and Movement Disorders Department, Centre Hospitalier Universitaire, Lille, France.,Degenerative & Vascular Cognitive Disorders, University of Lille, Lille, France
| | - Albert F G Leentjens
- Department of Psychiatry and Neuropsychology, Maastricht University Medical Centre, Maastricht, the Netherlands.,Research School of Mental Health and Neuroscience (Mhens), Maastricht University, Maastricht, the Netherlands
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Abstract
PURPOSE OF REVIEW This review summarizes the current state of evidence for palliative care (PC) in movement disorders, describes the application of PC to clinical practice, and suggests future research directions. RECENT FINDINGS PC needs are common in persons living with movement disorders and their families from the time of diagnosis through end-of-life and contribute to quality of life. Early advance care planning is preferred by patients, impacts outcomes and is promoted by PC frameworks. Systematic assessment of non-motor symptoms, psychosocial needs and spiritual/existential distress may address gaps in current models of care. Several complementary and emerging models of PC may be utilized to meet the needs of this population. A PC approach may identify and improve important patient and caregiver-centered outcomes. As a relatively new application of PC, there is a need for research to adapt, develop and implement approaches to meet the unique needs of this population.
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Affiliation(s)
- Zachary A Macchi
- Department of Neurology, University of Colorado, Aurora, CO Building 400, Mail Stop F429, 12469 E 17th Place, Aurora, CO, 80045, USA.
| | - Christopher G Tarolli
- Department of Neurology, University of Rochester, Rochester, NY, USA
- Center for Health + Technology, University of Rochester, Rochester, NY, USA
| | - Benzi M Kluger
- Department of Neurology, University of Rochester, Rochester, NY, USA
- Center for Health + Technology, University of Rochester, Rochester, NY, USA
- Department of Medicine, Palliative Care Division, University of Rochester, Rochester, NY, USA
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Maetzler W, Rochester L, Bhidayasiri R, Espay AJ, Sánchez-Ferro A, van Uem JMT. Modernizing Daily Function Assessment in Parkinson's Disease Using Capacity, Perception, and Performance Measures. Mov Disord 2020; 36:76-82. [PMID: 33191498 DOI: 10.1002/mds.28377] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 10/20/2020] [Accepted: 10/21/2020] [Indexed: 12/28/2022] Open
Abstract
Many disease symptoms restrict the quality of life of the affected. This usually occurs indirectly, at least in most neurological diseases. Here, impaired daily function is interposed between the symptoms and the reduced quality of life. This is reflected in the International Classification of Function, Disability and Health model published by the World Health Organization in 2001. This correlation between symptom, daily function, and quality of life makes it clear that to evaluate the success of a therapy and develop new therapies, daily function must also be evaluated as accurately as possible. However, daily function is a complex construct and therefore difficult to quantify. To date, daily function has been measured primarily by capacity (clinical assessments) and perception (surveys and patient-reported outcomes) assessment approaches. Now, daily function can be captured in a new dimension, that is, performance, through new digital technologies that can be used in the home environment of patients. This viewpoint discusses the differences and interdependencies of capacity, perception, and performance assessment types using the example of Parkinson's disease. Options regarding how future study protocols should be designed to get the most comprehensive and validated picture of daily function in patients are presented. © 2020 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Walter Maetzler
- Department of Neurology, Kiel University and University Hospital Schleswig-Holstein, Kiel, Germany
| | - Lynn Rochester
- Translational and Clinical Research Institute Campus for Ageing and Vitality, Newcastle University, Newcastle Upon Tyne, United Kingdom
| | - Roongroj Bhidayasiri
- Department of Medicine, Faculty of Medicine, Chulalongkorn Center of Excellence for Parkinson's Disease & Related Disorders, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - Alberto J Espay
- Department of Neurology, Gardner Center for Parkinson's Disease and Movement Disorders, University of Cincinnati, Cincinnati, Ohio, USA
| | | | - Janet M T van Uem
- Department of Neurology, Kiel University and University Hospital Schleswig-Holstein, Kiel, Germany
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Nielsen C, Siersma V, Ghaziani E, Beyer N, Magnusson SP, Couppé C. Health-Related Quality of Life and Physical Function in Individuals with Parkinson's Disease after a Multidisciplinary Rehabilitation Regimen-A Prospective Cohort Feasibility Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17207668. [PMID: 33096677 PMCID: PMC7589165 DOI: 10.3390/ijerph17207668] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 10/08/2020] [Accepted: 10/15/2020] [Indexed: 12/20/2022]
Abstract
Parkinson’s disease (PD) is a neurodegenerative disease and a multidisciplinary approach to rehabilitation has been suggested as the best clinical practice. However, very few studies have investigated the long-term effects of a multidisciplinary rehabilitation approach, particularly regarding whether this can slow the progression of PD. The purpose was to investigate the short- and long-term effect of a 2-week multidisciplinary rehabilitation regimen on the PD-related decline in health-related quality of life (HRQOL), mobility, and muscle function. Individuals with PD (IPD) participated in a 2-week inpatient multidisciplinary rehabilitation regimen that focused on improving HRQOL, mobility, and muscle function. Data from the primary outcome: HRQOL (Parkinson’s Disease Questionnaire 39, PDQ-39), secondary outcomes: handgrip strength, Timed-up and Go (TUG), Hospital Anxiety and Depression Scale (HADS), and Falls Efficacy Scale-International (FES-I) were compared at pre-visitation, before and after the 2-week regimen, and again at 4 and 10 months follow-up. In total, 224 patients with PD were included. There were short-term improvements in all outcomes. PDQ-39 was maintained at the same level as pre-visitation after 10 months follow-up. A 2-week multidisciplinary rehabilitation regimen improved short-term mobility, muscle function, and HRQOL in individuals with Parkinson’s disease. HRQOL was maintained after 10 months demonstrating long-term effects.
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Affiliation(s)
- Christina Nielsen
- Department of Physical and Occupational Therapy, Bispebjerg Hospital, 2400 Copenhagen, Denmark; (E.G.); (N.B.); (S.P.M.); (C.C.)
- Institute of Sports Medicine Copenhagen, Department of Orthopaedic Surgery M, Bispebjerg Hospital and Center for Healthy Aging, Faculty of Health and Medical Sciences, University of Copenhagen, 2400 Copenhagen, Denmark
- Correspondence: ; Tel.: +45-2095-2588
| | - Volkert Siersma
- Research Unit and Department of General Practice, Institute of Public Health, University of Copenhagen, 1014 Copenhagen, Denmark;
| | - Emma Ghaziani
- Department of Physical and Occupational Therapy, Bispebjerg Hospital, 2400 Copenhagen, Denmark; (E.G.); (N.B.); (S.P.M.); (C.C.)
| | - Nina Beyer
- Department of Physical and Occupational Therapy, Bispebjerg Hospital, 2400 Copenhagen, Denmark; (E.G.); (N.B.); (S.P.M.); (C.C.)
| | - S. Peter Magnusson
- Department of Physical and Occupational Therapy, Bispebjerg Hospital, 2400 Copenhagen, Denmark; (E.G.); (N.B.); (S.P.M.); (C.C.)
- Institute of Sports Medicine Copenhagen, Department of Orthopaedic Surgery M, Bispebjerg Hospital and Center for Healthy Aging, Faculty of Health and Medical Sciences, University of Copenhagen, 2400 Copenhagen, Denmark
| | - Christian Couppé
- Department of Physical and Occupational Therapy, Bispebjerg Hospital, 2400 Copenhagen, Denmark; (E.G.); (N.B.); (S.P.M.); (C.C.)
- Institute of Sports Medicine Copenhagen, Department of Orthopaedic Surgery M, Bispebjerg Hospital and Center for Healthy Aging, Faculty of Health and Medical Sciences, University of Copenhagen, 2400 Copenhagen, Denmark
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van Hienen MM, Contarino MF, Middelkoop HAM, van Hilten JJ, Geraedts VJ. Effect of deep brain stimulation on caregivers of patients with Parkinson's disease: A systematic review. Parkinsonism Relat Disord 2020; 81:20-27. [PMID: 33038702 DOI: 10.1016/j.parkreldis.2020.09.038] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 09/22/2020] [Accepted: 09/24/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Caregivers of patients with Parkinson's Disease (PD) often provide important support in the pre- and postoperative phase of Deep Brain Stimulation (DBS). DBS-associated changes of patient-functioning may affect caregiver wellbeing and impact the support system. Factors influencing caregiver-wellbeing under these circumstances are incompletely known. OBJECTIVE to systematically review studies of sufficient methodological quality on the impact of DBS on caregivers of PD patients. METHODS using PRISMA guidelines, major databases were searched up to May 2020. Five subcategories were identified: Caregiver burden, Caregiver cognitive and psychiatric functioning, Caregiver Quality of Life (QoL), Marital Satisfaction/Conflicts, and Caregiver Satisfaction. Quality was assessed using an in-house checklist. RESULTS 293 studies were identified; 12 were ultimately included. Caregiver burden, psychiatric and cognitive functioning and QoL remained relatively unchanged. Results on marital satisfaction/conflicts were contrasting: an increase in marital conflicts despite improved relationship quality scores DBS. Caregiver satisfaction with surgery was low with 50-58% of caregivers being disappointed with DBS outcomes. Concerning caregiver related factors: a higher preoperative caregiver QoL, younger age, lower scores on psychiatric rating scales, and more favourable preoperative relationship quality scores, were associated with better caregiver wellbeing. A favourable patient-profile includes younger age and age-at-onset, shorter disease duration, lower medication requirements, and lower scores on psychiatric rating scales. CONCLUSION Although most patient- and caregiver-related subdomains remained unchanged after DBS, dissatisfaction among caregivers and marital problems may constitute a large risk for a well-functioning patient-caregiver dyad. Early recognition of potential problem situations may improve post-DBS care for both patients and caregivers.
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Affiliation(s)
- Marle M van Hienen
- Department of Neurology, Leiden University Medical Center, Leiden, the Netherlands
| | - Maria Fiorella Contarino
- Department of Neurology, Leiden University Medical Center, Leiden, the Netherlands; Department of Neurology, Haga Teaching Hospital, the Hague, the Netherlands
| | - Huub A M Middelkoop
- Department of Neurology, Leiden University Medical Center, Leiden, the Netherlands; Institute of Psychology, Health, Medical and Neuropsychology Unit, Leiden University, Leiden, the Netherlands
| | - Jacobus J van Hilten
- Department of Neurology, Leiden University Medical Center, Leiden, the Netherlands
| | - Victor J Geraedts
- Department of Neurology, Leiden University Medical Center, Leiden, the Netherlands; Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands.
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Synergy of pandemics-social isolation is associated with worsened Parkinson severity and quality of life. NPJ PARKINSONS DISEASE 2020; 6:28. [PMID: 33083522 PMCID: PMC7545190 DOI: 10.1038/s41531-020-00128-9] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 08/13/2020] [Indexed: 01/15/2023]
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.
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Jones S, Torsney KM, Scourfield L, Berryman K, Henderson EJ. Neuropsychiatric symptoms in Parkinson's disease: aetiology, diagnosis and treatment. BJPSYCH ADVANCES 2020. [DOI: 10.1192/bja.2019.79] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
SUMMARYHistorically, Parkinson's disease was viewed as a motor disorder and it is only in recent years that the spectrum of non-motor disorders associated with the condition has been fully recognised. There is a broad scope of neuropsychiatric manifestations, including depression, anxiety, apathy, psychosis and cognitive impairment. Patients are more predisposed to delirium, and Parkinson's disease treatments give rise to specific syndromes, including impulse control disorders, dopamine agonist withdrawal syndrome and dopamine dysregulation syndrome. This article gives a broad overview of the spectrum of these conditions, describes the association with severity of Parkinson's disease and the degree to which dopaminergic degeneration and/or treatment influence symptoms. We highlight useful assessment scales that inform diagnosis and current treatment strategies to ameliorate these troublesome symptoms, which frequently negatively affect quality of life.
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