Mental health in people with Parkinson’s disease during the COVID-19 pandemic: potential for targeted interventions?

Abstract

The COVID-19 pandemic has introduced a myriad of challenges to the social life and care of people with Parkinson’s disease (PD), which could potentially worsen mental health problems. We used baseline data of the PRIME-NL study (N = 844) to examine whether the association between COVID-19 stressors and mental health is disproportionately large in specific subgroups of people with PD and to explore effects of hypothetical reductions in COVID-19 stressors on mental health and quality of life. The mean (SD) age of the study population was 70.3 (7.8) years and 321 (38.0%) were women. The linear regression effect estimate of the association of COVID-19 stressors with mental health was most pronounced in women, highly educated people, people with advanced PD and people prone to distancing or seeking social support. Smaller effect estimates were found in people scoring high on confrontive coping or planful problem solving. The parametric G-formula method was used to calculate the effects of hypothetical interventions on COVID-19 stressors. An intervention reducing stressors with 50% in people with above median MDS-UPDRS-II decreased the Beck Depression Inventory in this group from 14.7 to 10.6, the State-Trait Anxiety Inventory from 81.6 to 73.1 and the Parkinson’s Disease Quality of Life Questionnaire from 35.0 to 24.3. Insights from this cross-sectional study help to inform tailored care interventions to subgroups of people with PD most vulnerable to the impact of COVID-19 on mental health and quality of life.

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

“…Noteworthy, the largest impact resulted from social distancing, especially distancing from families, relatives, and friends and from feeling restricted to home/room—aspects that have been found before [ 14 , 32 ] and that seem to increase stress levels [ 24 , 32 ]. 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 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 ].…”

Psychological impact of COVID-19 pandemic on Parkinson's disease patients

“…As a result of the ongoing COVID-19 pandemic, people with Parkinson's disease (PD) may experience many consequences, including social distancing measures and lifestyle changes, increasing psychological stress and worsening symptoms. Researchers have recently uncovered a link between external stressors (the COVID-19 pandemic) and worsened Parkinson's symptoms by inciting psychological distress and influencing lifestyle modifications (reduced physical activity) [ 29 , 30 ]. The COVID-19 outbreak may be stressful for people around the world.…”

Parkinson's disease and Covid-19: Is there an impact of ethnicity and the need for palliative care

“…Disruptions in normal life introduced by the Covid-19 pandemic generated considerable psychological stress in community-dwelling PwP, a population with limited abilities of flexible adaptation to rapid and drastic changes in daily routines ( Dommershuijsen et al, 2021 ). Levels of anxiety (one of the most common neuropsychiatric features of PD) in PwP and their caregivers during the Covid-19 pandemic were significantly higher than in the general population; this appears to be associated with uncertainties regarding obtaining their medications and a perceived higher risk of contracting SARS-CoV-2 because of their underlying chronic medical condition ( Salari et al, 2020 ).…”