Creating a Metric to Determine Social Functioning in Parkinson Disease

How people engage with one another, and in society at large, is known as social functioning, but how social functioning is affected in patients without dementia who have Parkinson disease (PD) has not been widely studied. In a recent paper, researchers described a new metric called the Parkinson’s Disease Social Functioning Scale (PDSFS) that aims to measure social functioning in this population.

Impairment in social functioning may be one of those prodromal symptoms of PD that begin to emerge years before motor symptoms appear. In this study, the researchers wanted to see whether PDSFS scores are linked with cognitive status with PD. The PDSFS assesses family life, self-care, hobbies, interpersonal relationships, and social bonds.

A total of 302 participants were recruited, 181 with PD and 121 healthy adults who served as controls. Of the 181 patients with PD, 55 had mild cognitive impairment (MCI) and 126 were considered cognitively intact (CI). All underwent the Mini-Mental State Examination (MMSE) and PDSFS; 120 patients with PD completed the MMSE, Activities of Daily Living Scale and Neuropsychiatric Inventory.

The analysis included group comparisons, receiver operating characteristic curves, Spearman correlation and multiple and hierarchical regression analyses.

The analysis showed that patients with PD-MCI scored the lowest in all areas of the PDSFS (F = 10.10, P < 0.001).

The PDSFS cut-off score for PD-MCI was 53 (area under the curve 0.700, sensitivity 0.800, specificity 0.534). The low specificity indicates that a score between 40 and 53 for patients with PD means that “they were likely to experience challenges with their social functioning when dealing with complex functional tasks.”

The PDSFS score was predicted by the MMSE (β = 0.293, P = .002), Activities of Daily Living Scale (β = 0.189, P = .028), and the Neuropsychiatric Inventory (β = −0.216, P = .005).

Researchers also found an interaction effect between the Activities of Daily Living Scale and Neuropsychiatric Inventory scores on the PDSFS (β = 0.305, P < .001).

However, PDSFS scores were not significantly linked with demographics or measures of Parkinson’s severity.

Participants in the PD-CI group had similar social functioning as the healthy controls, although they were lower in areas related to social bonds; the authors suggested that PD creates issues of loneliness and isolation even when cognitive problems are not present.

“Although the overall social functioning of the of the PD-CI group is not different from that of healthy older adults, the impairment of ‘social bond’ cannot be ignored,” the researchers wrote.

In addition, “neuropsychiatric symptoms may influence patients’ social functioning,” the authors said.

The study was published in BJPsych Open.

Reference

Chen YR, Tan CH, Su HC, et al. Investigating the interaction between neuropsychiatry features and daily activities on social function in patients with Parkinson's disease with mild cognitive impairment. BJPsych Open. Published online November 25, 2022. doi.org/10.1192/bjo.2022.611