Lockdown effects on Parkinson’s disease during COVID-19 pandemic: a pilot study

Abstract

The coronavirus-disease 2019 (COVID-19) outbreak precipitated prolonged lock-down measures. The subsequent social distancing, isolation, and reduction in mobility increased psychological stress, which may worsen Parkinson’s disease (PD). Therefore, telemedicine has been proposed to provide care to PD patients. To evaluate the effects of lock-down on motor and nonmotor symptoms in PD patients during the COVID-19 pandemic and the feasibility of telemedicine. Motor and nonmotor aspects were longitudinally assessed using structured questionnaires at baseline (in-person, February 2020) and at follow-up (remote web-based video, lock-down) evaluation. Of the seventeen PD patients evaluated at baseline, fourteen agreed to participate in, and completed follow-up evaluations. There was an impairment of nonmotor aspects measured with the MDS-UPDRS part I (p < 0.001) during lock-down. Nine patients participated independently in the telemedicine evaluation while five needed help from relatives. Our preliminary findings suggest an impairment of nonmotor symptoms in PD patients and support the feasibility and need for telemedicine in monitoring PD patients during the COVID-19 pandemic, to guarantee optimal assistance with reducing the burden of infection. Our findings also suggest that movement disorder clinics should be carefully considering socio-demographics and clinical features when developing telemedicine programs.

Impact of COVID-19 Pandemic on (Health) Care Situation of People with Parkinson’s Disease in Germany (Care4PD)

“…However, our data indicate that although technical options were accessible in most PwP (even those with p-LTC, who additionally might not only need technical options but also care staff support to use the technology), acceptance and use of this technique was rather low in both groups. Although telemedicine approaches have been shown to be effective [ 60 , 61 ] and are widely recommended for PwP [ 16 , 32 , 62 ], even by the International Parkinson and Movement Disorder Society [ 1 ], our findings are congruent with previous studies documenting that even high levels of satisfaction with telemedicine did not translate into a sustained interest or use of this health care approach [ 2 , 12 ]. Extensive promotion of remote or virtual care modes that have been found to be as effective as in-person communication [ 63 ] or alternative offerings (e.g., conducting more house calls by medical and/or therapeutical staff, cross-sectoral approaches with PD nurse specialists as in other countries that are only rarely deployed in Germany so far [ 64 ]) should be focused on in the future.…”

“…In a previous study, high perceived stress in PwP was associated with lower social support [ 24 ], and COVID-19-related stressors were associated with mental health issues especially in female, highly educated people, people with advanced PD, and those vulnerable to distancing or seeking social support [ 65 ]. Moreover, other studies documented the negative impact of the pandemic on the health and function of PwP [ 2 , 16 , 18 , 29 , 65 ].…”

“…In addition to these suggestions and the general limitations, disruptions of everyday activities and reduced access to health care and therapists might further complicate the situation of people with Parkinson’s disease (PwP) during the COVID-19 pandemic. Global and regional studies from America (US, Canada, Brazil), Asia (China, Japan, South Korea, India, Iran Israel, Turkey), North Africa (Egypt), or European countries (Luxembourg, Netherlands, UK, Italy, Spain, Slovenia) reported wide-ranging consequences of the pandemic on PwP, such as worsened motor and non-motor symptoms [ 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 ], a negative impact on mental health [ 29 ], a decline in quality of life [ 20 , 21 , 30 ], disrupted social and medical activities [ 12 , 13 ], impaired access to PD medication [ 21 , 31 , 32 ], or other unmet needs such as emotional distress, problems with rescheduling appointments with health care providers, and reduction in physical activity [ 2 , 14 , 20 , 22 , 24 , 33 , 34 ]. On the other side, although hours of caregiving at home and caregiver burden increased [ 33 ], patients and caregivers seem to be well informed and to have coped well in some studies [ 35 , 36 , 37 ].…”

A Peek into Pandora’s Box: COVID-19 and Neurodegeneration

“…In addition to the direct adverse effects of SARS-CoV-2, the restrictive measures enforced due to COVID-19 such as home confinement and social distancing negatively impacted the general health and well-being of all individuals causing depression, anxiety and stress, and worsened the neuropsychiatric outcomes for AD patients [ 184 , 185 , 186 , 187 , 188 ]. Studies have shown that isolation and reduction in mobility increased psychological stress and produced an impairment of motor and nonmotor symptoms in PD patients [ 189 , 190 , 191 , 192 ]. There is also a prevalence of post-traumatic stress disorder (PTSD) among COVID-19 survivors and care givers [ 165 , 193 , 194 , 195 , 196 ].…”

Secondary Impact of COVID-19 Pandemic on People with Parkinson’s Disease—Results of a Polish Online Survey

“…Social distancing, isolation, increased psychological stress and reduction in mobility related to the COVID-19 pandemic have affected the lifestyle of people around the world [ 1 , 2 ]. The COVID-19 pandemic contributed to changing the management of patients with movement disorders [ 3 , 4 ].…”