Parkinson's Disease Symptoms Have a Distinct Impact on Caregivers' and Patients' Stress: A Study Assessing the Consequences of the <scp>COVID‐19 </scp> Lockdown

Oppo, Valentina; Serra, Giulia; Fenu, Giuseppe; Murgia, Daniela; Ricciardi, Lucia; Melis, Maurizio; Morgante, Francesca; Cossu, Giovanni

doi:10.1002/mdc3.13030

Cited by 26 publications

(45 citation statements)

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“…In this study, a high MDS-UPDRS part 2 score was shown to be a risk factor for clinical depression and anxiety. This is consistent with previous studies suggesting that reduced exercise time was associated with worsening of both motor and non-motor symptoms under COVID-19 pandemic [ 12 – 14 ] and that motor fluctuation and impairment of activities of daily life were significant risk factors for the development of depression [ 26 ]. In addition, we showed that a male sex was associated with clinical anxiety, while a female sex was reported to be a potential risk factor for anxiety both in general population and in PD patients [ 26 , 27 ].…”

Section: Discussionsupporting

confidence: 92%

“…Reasons for the high prevalence of subjective worsening of anxiety in controls may be related to the fact that they were caregivers, in addition to the fact that 84% of them are female. Oppo et al also reported that caregivers complained similar or higher levels of worsened mental stress than PD patients during home confinement due to COVID-19 pandemic (PD patients vs. caregivers, 43% vs 54%, respectively) [ 12 ]. It has been reported that caregivers of PD patients have a marked mental burden [ 28 , 29 ].…”

Section: Discussionmentioning

confidence: 99%

“…Regarding COVID-19, Lara et al showed that 30% of patients with Alzheimer’s disease and 40% of their caregivers reported worsening mental health conditions due to the COVID-19 lockdown [ 32 ]. Oppo et al also indicated that some non-motor symptoms such as mood, cognition, and urinary problems in PD patients caused additional mental burden on the caregivers [ 12 ]. In addition to caregivers’ own health concerns, feeling responsible for PD patients’ health status may have led to the high prevalence of subjective worsening of anxiety in controls in this study.…”

Section: Discussionmentioning

confidence: 99%

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Risk factors for neuropsychiatric symptoms in patients with Parkinson’s disease during COVID-19 pandemic in Japan

et al. 2021

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The worsening of neuropsychiatric symptoms such as depression, anxiety, and insomnia in patients with Parkinson’s disease (PD) has been a concern during the COVID-19 pandemic, because most people worked in self-isolation for fear of infection. We aimed to clarify the impact of social restrictions imposed due to the COVID-19 pandemic on neuropsychiatric symptoms in PD patients and to identify risk factors associated with these symptoms. A cross-sectional, hospital-based survey was conducted from April 22, 2020 to May 15, 2020. PD patients and their family members were asked to complete paper-based questionnaires about neuropsychiatric symptoms by mail. PD patients were evaluated for motor symptoms using MDS-UPDRS part 2 by telephone interview. A total of 71 responders (39 PD patients and 32 controls) completed the study. Although there was no difference in the age distribution, the rate of females was significantly lower in PD patients (35%) than controls (84%) (P < 0.001). Participants with clinical depression (PHQ-9 score ≥ 10) were more common in PD patients (39%) than controls (6%) (P = 0.002). Multivariate logistic regression analysis revealed that an MDS-UPDRS part 2 score was correlated with the presence of clinical depression (PHQ-9 score ≥ 10) and clinical anxiety (GAD-7 score ≥ 7) (clinical depression: OR, 1.31; 95% CI, 1.04–1.66; P = 0.025; clinical anxiety: OR, 1.36; 95% CI, 1.07–1.72; P = 0.013). In the presence of social restrictions, more attention needs to be paid to the neuropsychiatric complications of PD patients, especially those with more severe motor symptoms.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Risk factors for neuropsychiatric symptoms in patients with Parkinson’s disease during COVID-19 pandemic in Japan

et al. 2021

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“…During pandemic, an increase of psychological distress, depression, and anxiety have been observed in PD patients [ 4 – 6 ], which are at least partially related to individual perception of higher risk for a worse infection outcome [ 7 ] and reduced access to healthcare services [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

“…Importantly, higher distress was observed also in caregivers of patients with PD [ 4 ]. In such a complex picture, a more specific characterization of the psychological impact of COVID-19 on PD patients and their families is needed, with a special focus on the interaction with the heterogeneous motor and nonmotor symptoms occurring at different clinical stages.…”

Section: Introductionmentioning

confidence: 99%

Anxiety, depression, and worries in advanced Parkinson disease during COVID-19 pandemic

et al. 2021

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Background The psychological impact of the COVID-19 outbreak and lockdown on frail populations with advanced Parkinson disease (APD) and their caregivers may present with peculiar features and require specific interventions. Methods We enrolled here 100 APD patients and 60 caregivers. Seventy-four patients were treated with device-aided therapies (DAT) and 26 with standard medical treatment (SMT). Through a telephonic interview, subjects underwent the Hospital Anxiety and Depression Scale (HADS-A; HADS-D), and an ad hoc questionnaire to explore thoughts and emotions related to the pandemic. Results Depression was observed in 35% of APD patients and anxiety in 39%, with a significant reduction of the latter after the lockdown (p= 0.023). We found a significant correlation between the type of therapy and the HADS-A score (p= 0.004). Patients’ main worries were as follows: a possible higher risk of COVID-19 infection (25%), interruption of non-pharmacological treatments (35%), interruption of outpatient clinics (38%), PD complications related to COVID-19 (47%). Patients treated with DAT manifested worries about device-related issues and risk for caregivers’ infection. The 40% of caregivers showed anxiety, while the 21.7% of them showed depression. Conclusion Our study reveals a higher prevalence of anxiety and the presence of peculiar worries and needs in APD patients during the pandemic alongside psychological sequelae of their caregivers. These findings are important for neurologists and healthcare services to foster strategies for the management of psychological distress in both patients and caregivers.

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The Impact of the COVID‐19 Pandemic on Care Partners of People with Parkinson's Disease

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Hulshoff

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et al. 2023

Movement Disord Clin Pract

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Background Since the onset of the coronavirus disease 2019 pandemic, the caregiving routine for care partners of people with Parkinson's disease (PwPD) changed substantially. Objectives To understand the nature and severity of burden in care partners of PwPD during the ongoing pandemic. We also sought to describe care partners' perceived change in burden and factors associated with increased burden. Methods Cross‐sectional online questionnaire‐based study among care partners of PwPD, registered in the Fox Insight study. The questionnaire consisted of the Modified Caregiver Strain Index, whether an aspect of strain had changed over the course of the pandemic and additional pandemic‐specific infection and lifestyle‐related items. Results Two hundred seventy‐three non‐paid primary care partners responded to the questionnaire, 73% female with a median age at enrollment of 64 years, 56% reporting a household income greater than 75,000 USD per year, and 61% retired. An increase in burden compared to before the pandemic was prevalent, ranging from 33% to 63% for individual items. Emotional strain increased most frequently (63%). Decreases in burden were uncommon; work adjustments (7%) and time demands (6%) decreased most frequently. PD‐related factors and care partner roles in personal care of the PwPD were the factors that were associated with strain in multivariable analysis, whereas social and pandemic‐related factors were not. Conclusion In this affluent and mostly retired cohort, increases in emotional strain during the pandemic were prevalent. Despite this, caregiving roles in personal care and severity of symptoms in the PwPD were more strongly associated with strain than social and pandemic‐related factors.

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Parkinson's Disease Symptoms Have a Distinct Impact on Caregivers' and Patients' Stress: A Study Assessing the Consequences of the COVID‐19 Lockdown

Abstract: Valentina Oppo and Giulia Serra equally contributed to this article. Francesca Morgante and Giovanni Cossu share senior authorship. Relevant disclosures and conflicts of interest are listed at the end of this article.

Cited by 26 publications

References 7 publications

Risk factors for neuropsychiatric symptoms in patients with Parkinson’s disease during COVID-19 pandemic in Japan

Risk factors for neuropsychiatric symptoms in patients with Parkinson’s disease during COVID-19 pandemic in Japan

Anxiety, depression, and worries in advanced Parkinson disease during COVID-19 pandemic

The Impact of the COVID‐19 Pandemic on Care Partners of People with Parkinson's Disease

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