Predictors of Sustained Physical Activity During the COVID-19 Pandemic in People With Parkinson Disease in Sweden

Abstract

Background and Purpose: During the first wave of the COVID-19 pandemic, people with Parkinson disease (PwPD) reported deterioration in health and physical activity. The aim of this study was to describe 1-year changes in physical activity and perceived health in PwPD during the COVID-19 pandemic and to identify predictors of sustained physical activity. Methods: This study compared perceived health and sensor-derived physical activity (Actigraph GT3x) in PwPD between the first (June to July 2020) and third waves (June to July 2021) of the pandemic. Multiple logistic regression analyses were used to predict sustained physical activity across the study period using personal factors, disease severity, and functioning as independent variables. Results: Sixty-three PwPD (mean age 71.0 years, 41% females) completed both baseline and 1-year follow-up (26 lost to follow-up). PwPD showed a decrease in average number of steps per day (Δ415 steps, P = 0.048), moderate-to-vigorous-physical activity (Δ7 minutes, P = 0.007) and increase in sedentary time (Δ36 minutes, P <.001) between baseline and 1-year follow-up. While self-perceived walking impairments and depressive symptoms increased significantly, balance confidence decreased between baseline and 1-year follow-up, no significant changes occurred for self-rated health, quality of life, or anxiety. Significant predictors of sustained physical activity levels were 15 years or more of education (odds ratio [OR] = 7.38, P = 0.013) and higher perceived walking ability (OR = 0.18, P = 0.041). Discussion and Conclusion: Among PwPD with mild to moderate disease severity living in Sweden, factors associated with reduced physical activity levels during the COVID-19 pandemic included older age, lower education levels, and greater perceived walking difficulties. Video Abstract available for more insights from the authors (see the Video, the Supplemental Digital Content, available at: http://links.lww.com/JNPT/A451).

The impact of psychiatric comorbidity on Parkinson's disease outcomes: a systematic review and meta-analysis

“…The association of depression with subsequent cognitive impairment, disease progression, death, disability, falls or fractures and residential home admission was tested across 6324 participants in 29 studies. 18 , 19 , 20 , 21 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 Depression was significantly associated with cognitive impairment (SMD 0.37 [95% CI 0.10–0.65], p = 0.0085, I 2 27.1%, [ I 2 95% CI 0–35.0]), disease progression (SMD 0.46 [95% CI 0.18–0.74], p = 0.0011, I 2 52.2 [ I 2 95% CI 0–81.1]), and disability (SMD 0.42 [95% CI 0.25–0.60], p = <0.0001, I 2 7.9%, [ I 2 95% CI 0–91.2]). There was no significant association for falls or fractures (SMD −0.28 [95% CI −0.90 to 0.34], p = 0.37, I 2 0%, [ I 2 95% CI 0–99.5]) and death (SMD 0.32 [95% CI −0.56 to 1.20], p = 0.47, I 2 0% [ I 2 95% CI 0–37.0]).…”