Parkinson's disease and spirituality

Association between Religiousness and Quality of Life among Patients in Brazil diagnosed with Idiopathic Parkinson's Disease

The importance of religiousness in idiopathic Parkinson's disease (IPD) has been the subject of conflicting research. The impact of religiousness on quality of life and depressive symptoms has also been poorly studied in this population. This study investigated the correlation between religiousness and quality of life in patients with IPD. We evaluated 37 patients with IPD (according to the criteria of the Movement Disorders Society) who were from an outpatient clinic specializing in movement disorders in Brazil. We assessed the patients using the Duke University Religion Index and scales for motor impairment, cognition, quality of life, and depression. Spearman's test was used to check for possible correlations between the different dimensions of religiousness and the clinical variables analyzed. Patients with a worse quality of life and more depressive symptoms showed greater intrinsic religiousness.

Spirituality and Influencing Factors in Parkinson's Disease: A Scoping Review

Although the effect of spirituality in chronic disease has been discussed in recent years, little is known about spirituality and spiritual beliefs in Parkinson's disease. In this scoping review, the databases PubMed, Scopus and Web of Science were searched and initially identified 914 studies. A total of nine studies satisfied the inclusion criteria. It was found age, gender, education level, emotional changes, region of onset of Parkinson's disease, severity of symptoms, quality of life, religion affiliation and acceptance of Parkinson's disease influence spirituality in people with Parkinson's disease. In this context, future studies should focus on the relationship between Parkinson's disease and spirituality.

Belief in omens and superstitions among patients with chronic neurological disorders

Introduction

Chronic neurological disorders may affect various cognitive processes, including religiosity or superstitious belief. We investigated whether superstitious beliefs are equally prevalent in patients with Parkinson's disease (PD), people with epilepsy (PWE), patients with multiple sclerosis (MS) and healthy controls (HCs).

Methods

From late 2014 to early 2023 we conducted a cross-sectional in-person anonymous paper-based survey at the tertiary clinic of Vilnius University Hospital Santaros Klinikos among outpatients and HCs by asking them to ascribe meaning or report belief for 27 culturally adapted statements (9 omens and 18 superstitions). The sum of items that a respondent believes in was labeled the superstition index (SI). The SI was compared between groups by means of the Kruskal-Wallis (H) test and negative binomial regression modeling. A two-step cluster analysis was performed to discern different subgroups based on answers to the items of the SI.

Results

There were 553 respondents who completed the questionnaire (183 PWE, 124 patients with PD, 133 with MS and 113 HCs). Complete SI scores were collected for 479 (86.6%) participants and they were lower in patients with PD (n = 96, Md = 1, IQR = 0-5.75) in comparison to those with epilepsy (n = 155, Md = 6, IQR = 1-14), MS (n = 120, Md = 4, IQR = 0-12) or HCs (n = 108, Md = 4.5, IQR = 1-10), H (3) = 26.780, p < 0.001. In a negative binomial regression model (n = 394, likelihood ratio χ2 = 35.178, p < 0.001), adjusted for sex, place of residence, income and education, female sex was the only characteristic associated with the SI (β = 0.423, OR = 1.526, 95% CI = 1.148 to 2.028). Both female sex (β = 0.422, OR = 1.525, 95% CI = 1.148 to 2.026) and Parkinson's disease (β = -0.428, OR = 0.652, 95% CI = 0.432 to 0.984) were significant predictors of the SI when age was removed from the model. Two-step cluster analysis resulted in individuals with PD being grouped into "extreme non-believer," "non-believer" and "believer" rather than "non-believer" and "believer" clusters characteristic for PWE, patients with MS and HCs.

Conclusion

Our study suggests that individuals with PD believe in less superstitions than patients with MS, PWE or HCs. The results of this investigation should be independently confirmed after adjusting for PD-specific variables.

Spirituality in Parkinson's Disease within a Sample from the USA

Spirituality and religious beliefs are important for coping with medical conditions. The dopaminergic system is involved in reward behavior, and its dysfunction in Parkinson Disease (PD) raises questions about religiosity and spirituality in people with PD. This study examines the association between levels of spirituality and religiosity and the severity of PD motor and non-motor symptoms. The secondary aim investigates the perceived impact of PD diagnosis on spirituality and religiosity. This was a cross-sectional analysis of demographic, physical, mental, and spirituality and religiosity status in patients with PD recruited for the Health Outcomes Measurement (HOME) Study at the University of Maryland Parkinson Disease and Movement Disorders Center, Baltimore, USA. Spirituality and religiosity were assessed using the Spiritual Well-being Scale, and the World Health Organization Quality of Life Spiritual Religious and Personal Belief field-test instrument. The sample size was 85 PD patients. The mean age (standard deviation) was 65.5 (9.4) years and 67.1% were male. Higher levels of spirituality and religiosity were associated with younger age, sex (female), less education, religious affiliation (Christian), and mental health status. After adjusting for age, education, gender, race, marital status, religion, physical health, mental health, and comorbidity, only anxiety was associated with all of the spirituality/religiosity assessments. The majority of patients reported no change in their religious or spiritual beliefs following diagnosis. Greater spirituality and religiosity were associated with less anxiety. Also, younger women with PD showed higher levels of spirituality and religiosity. Longitudinal studies on more diverse populations are needed.

Religiosity and Risk of Parkinson's Disease in England and the USA

Parkinson's disease (PD) is associated with low religiosity cross-sectionally. Whether low religiosity might be associated with an increased risk for developing PD is unknown. This study investigated whether low religiosity in adulthood is associated with increased risk for developing PD. A population-based prospective cohort study was conducted. Participants from the English Longitudinal Study of Aging and the Midlife in the United States study who were free from PD at baseline (2004-2011) and completed questionnaires on self-reported religiosity, were included in a pooled analysis. Incident PD was based on self-report. Multivariable logistic regression was used to estimate odds ratios (OR) for developing PD according to baseline religiosity, with adjustment for sociodemographic characteristics, health and lifestyle factors and engagement in religious practices. Among 9,796 participants in the pooled dataset, 74 (0.8%) cases of incident PD were identified during a median follow-up of 8.1 years. In the fully adjusted model, compared with participants who considered religion very important in their lives at baseline, it was found that participants who considered religion "not at all important" in their lives had a tenfold risk of developing PD during follow-up (OR, 9.99; 95% CI 3.28-30.36). Moreover, there was a dose-response relationship between decreasing religiosity and increasing PD risk (P < 0.001 for trend). These associations were similar when adjusting for religious upbringing and when cases occurring within the first two years of follow-up were excluded from the analysis. The association was somewhat attenuated when religious practices were removed from the model as covariates, though it remained statistically significant (OR for "not at all important" vs. "very important", 2.26; 95% CI 1.03-4.95) (P < 0.029 for trend). This longitudinal study provides evidence for the first time that low religiosity in adulthood may be a strong risk factor for developing PD.

Religiosity in patients with amyotrophic lateral sclerosis, a cross-country comparison

PURPOSE

Amyotrophic lateral sclerosis (ALS) is a progressive motor impairment leading to early death. Religiousness is one of the factors potentially alleviating the psychological burden of patients. However, its role might vary according to cultural context. Our study aimed to analyze religiosity, and its clinical, psychological and socio-demographic correlates in ALS patients and controls, comparing two European countries with different cultural backgrounds.

METHODS

268 Polish and German ALS patients, including 18 with locked-in syndrome (LIS) and 198 healthy controls (HC) were interviewed about religiousness, quality of life (Qol), depression, functional status and pain. A follow-up was conducted on 71 patients.

RESULTS

Polish subjects had a significantly higher level of public, private and general religiosity than the German sample. Importantly, we found no difference in total and public religiousness between ALS patients and HC within either population. Only the private religiousness was significantly higher in German patients compared to controls. In the same sample, private religiousness correlated with functional impairment due to disease progression. In ALS groups and LIS patients, religiousness did not correlate with any disease-associated factors: disease duration, pain, Qol or depression. Follow-up comparisons in the ALS group revealed worsening functional status, increased depression and no significant change in religiosity.

CONCLUSIONS

Religiosity was linked to the cultural background rather than ALS. Generally, it did not correlate with clinical, psychological and socio-demographic parameters and was stable throughout disease progression. The only exception was the relationship between the functional decline and private religiosity among German patients.