Social isolation, loneliness and mental health sequelae of the Covid-19 pandemic in Parkinson's disease

The value of consciousness coaching in Parkinson's disease: Experiences and possible impact of holistic coaching

Background

People with a chronic condition such as Parkinson's disease (PD) struggle with acceptance and finding meaning in life. Consciousness coaching could be a valuable addition in addressing these issues.

Objective

We aim to evaluate the user experiences and potential effectiveness of consciousness coaching for people with PD (PwPD).

Methods

We performed a pilot randomized controlled trial including PwPD in Hoehn & Yahr stage 1-3. People with cognitive impairments, severe psychiatric disorders, or those who did not have a clear issue to address with consciousness coaching, were excluded. PwPD were randomly allocated to either receiving 6 months of consciousness coaching in addition to usual care or to usual care alone. To explore experiences we performed semi-structured qualitative interviews with all PwPD in the intervention group. Potential effects were explored using questionnaires on quality of life, activities of daily life, self-management and non-motor symptoms at baseline and after 6 months.

Results

We included 39 PwPD, 19 participants in the intervention group and 20 in the control group. Based on the interviews, we identified a number of themes and codes. In general PwPD experienced consciousness coaching as confronting but supportive in reaching their goals and in taking more responsibility for their lives. Quantitatively, we did not find a difference between groups for any of the outcomes.

Conclusions

Consciousness coaching was considered valuable by most participants in this study and may be an interesting addition to PD treatment. We did not find any effects of the intervention on PD symptoms or quality of life.

A Prescription for Wellness in Early PD: Just What the Doctor Ordered

BACKGROUND

Being diagnosed with a neurodegenerative disease is a life-changing event and a critical time to help patients cope and move forward in a proactive way. Historically, the main focus of Parkinson's disease (PD) treatment has been on the motor features with limited attention given to non-motor and mental health sequelae, which have the most impact on quality of life. Although depression and anxiety have been described at the time of PD diagnosis, demoralization, intolerance of uncertainty, decreased self-efficacy, stigma and loneliness can also present and have negative effects on the trajectory of the disease. Hence, understanding the psychological impact of the diagnosis and how to provide better counselling at this critical time point may be the key to a better long-term trajectory and quality of life.

FOCUS

There has been a paradigm shift in the treatment of chronic illness moving beyond the medical model, which focuses on fighting illness with the physician being in charge of the treatment process and the patient being the passive recipient, toward a more holistic (i.e., physical, psychological, social, and spiritual health) biopsychosocial approach that emphasizes behavioral factors with the patient being an active collaborator in their treatment. Hence, we propose that fostering resilience, social support, and psychological flexibility offer promise toward attenuating negative reactions and improving overall well-being.

CONCLUSION

Through a proactive wellness approach incorporating lifestyle choices, people with PD (PwP) can not only achieve improved states of health, well-being, and quality of life, but actually thrive.

Staying hidden: The burden of stigma in PD

BACKGROUND

Despite the myriad motor and non-motor challenges associated with Parkinson's disease (PD) diagnosis, the hidden issue of stigma may be among the most influential factors negatively affecting quality of life. A number of qualitative studies have been published assessing various aspects of stigma in PD, and quantitative studies assert that most people with PD experience stigma during the course of their disease. Stigma is associated with poorer mental and physical health, poorer quality of life, decreased levels of hope, self-esteem and self-efficacy. The resulting stigma can lead to social anxiety and isolation, reluctance to seek medical care, loneliness, depression and anxiety. Therefore, understanding what stigma is, where it comes from, and how it affects people living with PD may offer clinicians and care partners tools to help mitigate the negative effects.

FOCUS

Over the past few decades, we have seen a move away from simply focusing on the effects of a disease (medical model) toward a holistic biopsychosocial approach that considers the role of environmental factors (stigma) when assessing overall well-being. We review some proactive practical suggestions to help people living with PD effectively combat the negative effects of stigma.

CONCLUSION

The additional hidden burden of stigma from PD affects quality of life. Having a better understanding of the role of stigma and its impact may allow clinicians to provide proactive care and greater empathy for those living with the challenges of this disease.

SARS-CoV-2 and Parkinson's Disease: A Review of Where We Are Now

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), which causes coronavirus disease 2019 (COVID-19), has been discussed in the context of Parkinson's disease (PD) over the last three years. Now that we are entering the long-term phase of this pandemic, we are intrigued to look back and see how and why the community of patients with PD was impacted and what knowledge we have collected so far. The relationship between COVID-19 and PD is likely multifactorial in nature. Similar to other systemic infections, a probable worsening of PD symptoms secondary to COVID-19, either transient or persistent (long COVID), has been demonstrated, while the COVID-19-related mortality of PD patients may be increased compared to the general population. These observations could be attributed to direct or indirect damage from SARS-CoV-2 in the central nervous system (CNS) or could result from general infection-related parameters (e.g., hospitalization or drugs) and the sequelae of the COVID-19 pandemic (e.g., quarantine). A growing number of cases of new-onset parkinsonism or PD following SARS-CoV-2 infection have been reported, either closely (post-infectious) or remotely (para-infectious) after a COVID-19 diagnosis, although such a link remains hypothetical. The pathophysiological substrate of these phenomena remains elusive; however, research studies, particularly pathology studies, have suggested various COVID-19-induced degenerative changes with potential associations with PD/parkinsonism. We review the literature to date for answers considering the relationship between SARS-CoV-2 infection and PD/parkinsonism, examining pathophysiology, clinical manifestations, vaccination, and future directions.

Social support and psychosocial well-being among older adults in Europe during the COVID-19 pandemic: a cross-sectional study

The objective of the study was to identify the association between social support and psychosocial well-being among men and women aged over 65 years in Europe during the COVID-19 pandemic.

METHODS

Cross-sectional data on 36 621 men (n=15 719) and women (n=20,902) aged 65 years or higher were obtained from the ninth round of the Survey of Health, Ageing and Retirement in Europe. The outcomes were measured by psychosocial well-being reflected with self-reported depression, nervousness, loneliness and sleep disturbances. Social support was measured in terms of receiving help from own children, relatives and neighbours/friends/colleagues since the pandemic outbreak.

RESULT

About one-third of the participants reported depression (31.03%), nervousness (32.85%), loneliness (32.23%) and sleep trouble (33.01%). The results of multivariable regression analysis revealed that social support was a protective factor to psychological well-being. For instance, receiving help from own children (RD=-0.13, 95% CI=-0.14 to -0.12), relatives (RD=-0.08, 95% CI=-0.11 to -0.06), neighbours/friends/colleagues (RD=-0.11, 95% CI=-0.13 to -0.09) and receiving home care (RD=-0.20, 95% CI=-0.22 to -0.18) showed significantly lower risk difference for depression. Similar findings were noted for loneliness, nervousness, and sleep trouble as well, with the risk difference being slightly different for men and women in the gender-stratified analysis. For instance, the risk difference in depression for receiving help from own children was -0.10 (95% CI=-0.12 to -0.08) among men compared with -0.12 (95% CI=-0.14 to -0.11) among women. The risk differences in the outcome measures were calculated using generalised linear model for binomial family.

CONCLUSION

Findings of the present study highlight a protective role of social support on psychological well-being among both men and women. Developing strategies to promote social support, especially among older adults, may mitigate the rising burden of psychological illness during the COVID-19 pandemic.

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

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.

Quality of Life in Patients With Parkinson's Disease: A Cross-Sectional Study

Patients with Parkinson's disease (PD) suffer from a range of physical, psychological, and social problems. The disease affects the quality of life (QOL) of the affected person. Several factors contribute to QOL, and these factors should be examined to develop appropriate strategies. This study aimed to determine the factors related to QOL in patients with PD. A cross-sectional, descriptive study was conducted using a tool with strong validity and reliability (39-Item Parkinson's Disease Questionnaire (PDQ-39)) to assess the quality of life. Descriptive statistics were used to analyze the data, and non-parametric chi-square tests were applied to evaluate the relationship between QOL and the variables. Frequent hospital admissions, level of education, and marital status were among the factors that affected QOL. The ability to perform Ramadan fasting correlated with the degree of QOL. The coronavirus disease 2019 (COVID-19) pandemic has adversely affected the quality of life due to changes in access to medical care and medications. To improve QOL in patients with PD, a comprehensive approach is required in many healthcare domains that includes physiotherapy together with the conventional pharmacotherapy, other treatments, and psychological support.

Parkinson's Pals: A Student-Led Program to Facilitate Intergenerational Connections and Promote Psychosocial Well-Being Among Persons with Parkinson's Disease

Parkinson's disease (PD) causes unique motor and non-motor symptoms. Despite symptomatic treatment with pharmacotherapies, many persons with PD report feelings of loneliness and demoralization as their disease progresses. These symptoms greatly interfere with quality of life, necessitating novel treatment strategies. In this report, we introduce a new student-led program to improve psychosocial well-being among persons with PD by pairing them with college students. Through weekly one-on-one meetings, students gain a deeper understanding of PD, while patients gain a new social outlet and purpose. Based on the program's initial successes, we advocate for the adoption of similar programs at universities worldwide.

The plight of loneliness in Parkinson's disease: New opportunities

The human phenomenon of loneliness has been increasing in prominence across societies, with precipitous increase since COVID-19, and individuals with Parkinson's disease are not unscathed. Loneliness is of clinical relevance as it is cross-sectionally related to, and longitudinally precedes, mortality and other health risks, including worse motor, cognitive, and behavioral-psychological functioning. Relatively few studies have evaluated loneliness, or associated social experiences, in the context of Parkinson's, but the existing data is provocative. The authors advocate for clinicians' awareness and researchers' investigational focus.