Pandemic-Related Social Isolation Linked With Worsening Symptom Severity, Quality of Life in Parkinson Disease

Amid the coronavirus disease 2019 (COVID-19) pandemic, patients with Parkinson disease (PD) reporting feelings of loneliness were found to experience greater severity of symptoms, with social isolation also associated with greater patient-reported PD severity and lower quality of life, according to study findings published in NPJ Parkinson Disease.

The implications of the COVID-19 pandemic on patients with PD (PwP) has been a topic of debate, particularly whether PwP have a greater risk of infection and adverse outcomes than the general population.

While those with the condition have not been distinguished as an at-risk population for COVID-19, a prior interview on this topic indicated that similar to any other infection, COVID-19 can cause worsening of motor and nonmotor symptoms. Moreover, the adverse psychological impact of the pandemic was referenced as a cause for concern in the PD community, as PwP are already at an increased risk for symptoms of depression and anxiety, which now may be further exacerbated.

Authors of the current study sought to further investigate the impact of social isolation among PwP. “Social isolation is a risk factor for worsened health outcomes and increased mortality,” they explained. “There is a paucity of research on social isolation in PD, which is all the more critical now in the setting of social distancing due to COVID-19.”

Recruiting patients with idiopathic PD (n = 1527), researchers surveyed participants to assess whether social isolation is associated with PD symptom severity and quality of life. In the study, the primary outcome measures were patient-reported outcomes in PD (PRO-PD) and questions from PROMIS Global related to social health.

When examining survey data, researchers found an inverse relationship between PRO-PD scores and social performance and social satisfaction scores. Among PwP who reported being lonely, a 55% greater symptom severity was observed compared with those who were not lonely (P < .01).

Additionally, PwP who reported having a lot of friends were shown to exhibit 21% fewer symptoms than those with few or no friends (P < .01). “Social isolation was associated with greater patient-reported PD severity and lower quality of life, although it is unclear whether this is the cause and/or a consequence of the disease,” the researchers explained.

In concluding, the study authors highlighted the need to keep PwP socially connected and prevent loneliness amid social distancing regulations precipitated by the COVID-19 pandemic. “Proactive use of virtual modalities for support groups and social prescribing should be explored,” they wrote.

Reference

Subramanian I, Farahnik J, Mischley LK. Synergy of pandemics-social isolation is associated with worsened Parkinson severity and quality of life. NPJ Parkinsons Dis. Published online October 8, 2020. doi:10.1038/s41531-020-00128-9