Mental health in people with Parkinson\u2019s disease during the COVID-19 pandemic: potential for targeted interventions?

L. J. Dommershuijsen,E. M. Van den Berg,J. A. Labrecque,M. K. Ikram,M. A. Ikram,S. K. L. Darweesh,R. C. Helmich,B. R. Bloem,A. Van der Heide

doi:10.1038/s41531-021-00238-y

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.

Highlights

Depressive and anxiety symptoms are common in people living with Parkinson’s disease (PD)[1,2] and can substantially worsen quality of life[3]
In an additional analysis of the Personalized Parkinson Project (PPP) data, we found an association between the COVID-19 stressor sum score (0–25) and pre-COVID-19 BDI, State-Trait Anxiety Inventory (STAI) and PDQ-39
Because of the limited number of people with parkinsonism in these analyses, the confidence intervals were very wide and the differences between the groups uncertain. In this cross-sectional study among people with PD, we found that the association between COVID-19 stressors and mental health was more pronounced in women, highly educated people, people with advanced PD and people prone to distancing or seeking social support

Summary

Introduction

Depressive and anxiety symptoms are common in people living with Parkinson’s disease (PD)[1,2] and can substantially worsen quality of life[3]. The COVID-19 pandemic has introduced challenges to both access to care and to the social life of people with PD, which could potentially worsen mental health problems[4,5,6]. In order to slow infection rates of the SARS-CoV-2 virus, drastic social distancing measures have been taken[7]. These disruptions in normal life have caused considerable psychological stress in community-dwelling individuals[8]. Due to the deficient central dopaminergic transmission, people with PD typically have disproportionate difficulties with flexible adaptation to rapid and drastic changes in daily routines[14], such as those introduced by the COVID-19 pandemic[9]

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