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1.
Parkinsonism Relat Disord ; 93: 97-102, 2021 12.
Article in English | MEDLINE | ID: covidwho-2119837

ABSTRACT

Inequalities in mental healthcare and lack of social support during the COVID-19 pandemic have lowered quality of life and increased overall burden of disease in people with Parkinson's (PWP). Although the pandemic has brought attention to these inequalities, they are long standing and will persist unless addressed. Lack of awareness of mental health issues is a major barrier and even when recognized disparities based on race, gender, and socioeconomic factors limit access to already scarce resources. Stigma regarding mental illness is highly prevalent and is a major barrier even when adequate care exists. Limited access to mental healthcare during the pandemic and in general increases the burden on caregivers and families. Historically, initiatives to improve mental healthcare for PWP focused on interventions designed for specialty and academic centers generally located in large metropolitan areas, which has created unintended geographic disparities in access. In order to address these issues this point of view suggests a community-based wellness model to extend the reach of mental healthcare resources for PWP.


Subject(s)
Healthcare Disparities/trends , Mental Disorders/therapy , Mental Health/trends , Parkinson Disease/therapy , Social Support/trends , Health Resources/trends , Humans , Mental Disorders/epidemiology , Mental Disorders/psychology , Parkinson Disease/epidemiology , Parkinson Disease/psychology , Social Support/psychology
2.
Ann Clin Transl Neurol ; 9(10): 1504-1513, 2022 10.
Article in English | MEDLINE | ID: covidwho-2013308

ABSTRACT

BACKGROUND: The clinical, neuropsychological, and socioeconomic factors affecting Parkinson's disease (PD) during COVID-19 pandemic across different populations have not been systematically studied. To address this, we conducted a meta-analysis of factors that impact the well-being of PD patients during the pandemic. METHODS: Medline and Embase were searched for articles published between 2020 and 2022. We conducted random-effects pooling of estimates and meta-regression. RESULTS: Twenty-seven studies involving 13,878 patients from America, Europe, Asia, and Africa were included. There is a high prevalence of decreased physical activity and exercise, and worsening motor and neuropsychiatric symptoms (17-56%). Patients in lower-income countries more frequently reported worsening anxiety (adjusted OR [aOR] 8.94, 95% confidence interval [CI] 1.62-49.28, p = 0.012), sleep (aOR 5.16, 95% CI 1.15-23.17, p = 0.032), and PD symptoms (aOR 3.57, 95% CI 0.96-13.34, p = 0.058). Lockdown was associated with decreased exercise levels (aOR 0.13, 95% CI 0.02-0.78, p = 0.025) and worsening mood (aOR 0.48, 95% CI 0.24-0.95, p = 0.035). Younger age correlated with decreased physical activity (ß -0.30, 95% CI -0.53 to -0.07, p = 0.012), exercise (ß -0.11, 95% CI -0.15 to -0.07, p < 0.001), worsening PD symptoms (ß -0.08, 95% CI -0.15 to -0.01, p = 0.018), and sleep (ß -0.14, 95% CI -0.27 to 0, p = 0.044). Female PD patients reported a greater decrease in physical activity (ß 11.94, 95% CI 2.17-21.71, p = 0.017) and worse sleep (ß 10.76, 95% CI 2.81-18.70, p = 0.008). CONCLUSION: This large meta-analysis of PD patients in diverse populations identified a high prevalence of physical and mental worsening during the COVID-19 pandemic, with patients in lower-income countries being exceptionally vulnerable.


Subject(s)
COVID-19 , Parkinson Disease , Anxiety/epidemiology , Anxiety/etiology , Communicable Disease Control , Female , Humans , Pandemics , Parkinson Disease/complications , Parkinson Disease/epidemiology , Parkinson Disease/psychology
3.
J Clin Neurosci ; 102: 101-108, 2022 Aug.
Article in English | MEDLINE | ID: covidwho-1907340

ABSTRACT

BACKGROUND: There were concerns about the psychological outcomes of coronavirus disease from the beginning of the pandemic. Parkinson's disease (PD) patients seem to be more vulnerable to mental health disorders like stress, depression, anxiety, or worsening quality of life during COVID-19 lockdown. We aimed to conduct a systematic review to investigate the psychological outcomes of COVID-19 among the PD population. METHODS: A systematic search was conducted using PubMed, Scopus, and Web of Science. We included original studies which reported the psychological impact of COVID-19 in the PD population with a minimum of 10 cases. RESULTS: After the screening, 21 studies with a total of 5236 PD cases were included in our qualitative synthesis. Depression, anxiety, and to less extent sleep disorders and apathy are the most studied psychological outcomes. Most of the studies indicated that the severity or the prevalence of psychiatric disturbance increased due to the COVID-19 pandemic in PD patients. The prevalence of anxiety was 14% to 66.5%, while depression was reported in 0% to 50% of PD patients during and after the pandemic. Also, sleep problems were reported in 35.4% to 68.9% of PD patients. CONCLUSION: Considering the overall trend of increment in the severity of the main psychological outcomes observed in the present systematic review, it is suggested that future studies conduct a more accurate analysis of the prevalence, severity, and associated pathology of psychological outcomes of COVID-19 in PD patients.


Subject(s)
COVID-19 , Parkinson Disease , Anxiety/epidemiology , Anxiety/etiology , Anxiety/psychology , COVID-19/epidemiology , Communicable Disease Control , Depression/epidemiology , Depression/etiology , Depression/psychology , Humans , Pandemics , Parkinson Disease/complications , Parkinson Disease/epidemiology , Parkinson Disease/psychology , Quality of Life , Stress, Psychological/epidemiology
4.
Mov Disord ; 37(6): 1289-1294, 2022 06.
Article in English | MEDLINE | ID: covidwho-1763265

ABSTRACT

BACKGROUND: Telehealth has been widely adopted in providing Parkinson's disease care during the coronavirus disease 2019 pandemic. OBJECTIVE: The aim of this study was to survey people living with Parkinson's disease (PwPD) about their attitudes toward and utilization of telehealth services. METHODS: A survey was administered to PwPD via Parkinson's Foundation and Columbia University mailing lists. RESULTS: Of 1,163 responses, 944 complete responses were analyzed. Telehealth awareness was 90.2% (850/942), and utilization was 82.8% (780/942). More than 40% of PwPD were equally or more satisfied with telehealth compared with in-person visits in all types of services used. The highest satisfaction was observed in speech-language pathology appointments (78.8%, 52/66) followed by mental health services (69.2%, 95/137). CONCLUSIONS: In selected circumstances and indications, such as speech-language pathology and mental health services, telehealth may be a useful tool in the care of PwPD beyond the coronavirus disease 2019 pandemic. © 2022 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson Movement Disorder Society.


Subject(s)
COVID-19 , Parkinson Disease , Telemedicine , Attitude , Humans , Parkinson Disease/psychology , Parkinson Disease/therapy , Surveys and Questionnaires
6.
Rinsho Shinkeigaku ; 62(1): 8-14, 2022 Jan 28.
Article in Japanese | MEDLINE | ID: covidwho-1579997

ABSTRACT

We conducted the multicenter questionnaire survey targeting patients with Parkinson's disease (PD) in order to investigate the impacts on their daily lives and their requests to hospitals in the pandemic of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Mainly using open-ended questionnaire, we asked their anxiety, troubles they are facing, and requests toward hospitals in the pandemic of SARS-CoV-2. Two hundred fifth-eight PD patients answered the questionnaire. There were various opinions about anxiety such as "PD patients are susceptible and vulnerable to SARS-CoV-2" (36.8%). Concerning the troubles in the pandemic, the most frequent answer was that they couldn't participate in the rehabilitation and elderly day care (38.4%). Relatively many PD patients requested telemedicine (29.5%), whereas some people hoped face-to-face medical care (8.1%). There were demands about the delivery of medications (50.0%), the establishment of telephone consultations (43.8%), resources for rehabilitation at home (43.8%). The medical care adapted to the anxiety, trouble and requests of PD patients will be required in the era when we have to live with SARS-CoV-2.


Subject(s)
COVID-19 , Health Care Surveys , Health Surveys , Pandemics , Parkinson Disease/psychology , Parkinson Disease/therapy , Patients/psychology , Aged , Anxiety , COVID-19/epidemiology , Humans , Parkinson Disease/rehabilitation , Telemedicine
7.
PLoS One ; 16(12): e0260317, 2021.
Article in English | MEDLINE | ID: covidwho-1546952

ABSTRACT

BACKGROUND: During the SARS CoV-2 pandemic, telemedicine experienced an enormous boom. Also, for Parkinson's patients there are upcoming alternatives to regular care. OBJECTIVE: The aim of the present study was to interview Parkinson's patients under the impression of the first lockdown in Germany about their health care situation, but especially about the use of and attitudes towards videotherapy and -consultation. METHODS: Northern German members of the German Parkinson Association were mailed a 16-item questionnaire including demographic questions on a one-time basis. The voluntary participants answered regarding their health care situation during the first German SARS CoV-2 lockdown, as well as attitudes towards videotherapy/-consultations. RESULTS: The 332 (of 974 questionnaires) responding evaluated their care situation predominantly (58.7%) unchanged during lockdown. There was hardly any previous experience in the areas of videotherapy and -consultations (15.4% and 3%, respectively), but at the same time mostly imaginability of implementation (54.2% and 56%, respectively) and the belief that they could motivate themselves to do so (51.8%). A total of 69% welcomed technical support for the implementation of videotherapy. CONCLUSION: In principle, there seems to be both, a need and an interest in telematics in healthcare such as videotherapy and video consultations, even if further barriers such as technical implementation need to be addressed. An expansion of telemedical services and infrastructure seems desirable not only in the pandemic situation, but also in the long term against the backdrop of demographic change, especially in an area like Schleswig-Holstein. Further studies are needed.


Subject(s)
Attitude to Health , COVID-19 , Parkinson Disease/therapy , Telemedicine , Adult , Aged , Aged, 80 and over , COVID-19/epidemiology , Cross-Sectional Studies , Female , Germany , Humans , Male , Middle Aged , Parkinson Disease/psychology , Remote Consultation , Surveys and Questionnaires
8.
Parkinsonism Relat Disord ; 91: 66-76, 2021 10.
Article in English | MEDLINE | ID: covidwho-1377808

ABSTRACT

BACKGROUND: The COVID-19 pandemic has necessitated the social isolation of the population and the rapid implementation of remote care for patients with neurodegenerative diseases. The objective of this study was to explore the perceived impact of confinement in patients with Parkinson's disease and document the effects of gender and living environment. METHODS: We recruited two cohorts from the Canadian provinces of Québec and Alberta, which differed in the dynamics of COVID-19 spreading at the time of the study, and administered a questionnaire on the perceived effects of confinement on daily living and disease management. RESULTS: The data reveals that approximately half of the patients experienced a change in one or more clinical symptoms, with differences observed between gender (e.g. day-to-day changes in slowness in men, aggravated headaches in women) and geographic location (e.g. increased depression in Alberta but reduced sleep quality in Québec). Furthermore, participants identifying as women or living in Alberta implemented more frequently home or online exercise. Lastly, high levels of satisfaction with phone or video consultations did not translate into a sustained interest to pursue this mode of healthcare. CONCLUSIONS: This study suggests that COVID-19-related confinement affected Parkinson's disease manifestation and management. Patients also reported varying levels of interest to continue remote care. A number of differences reported in our study were seemingly related to gender and living environment.


Subject(s)
Attitude to Health , COVID-19 , Exercise , Parkinson Disease/therapy , Social Isolation , Telemedicine , Activities of Daily Living , Aged , Alberta , Canada , Cohort Studies , Disease Management , Female , Humans , Male , Middle Aged , Parkinson Disease/physiopathology , Parkinson Disease/psychology , Quebec , Residence Characteristics , SARS-CoV-2 , Sex Factors
9.
BMC Neurol ; 21(1): 326, 2021 Aug 24.
Article in English | MEDLINE | ID: covidwho-1371955

ABSTRACT

BACKGROUND: Parkinson's Disease (PD) is a highly prevalent neurodegenerative disease whose incidence is increasing with an aging population. One of the most serious manifestations of PD is gait instability, leading to falls and subsequent complications that can be debilitating, even fatal. Boxing therapy (BT) uses gait and balance exercises to improve ambulation in people with PD, though its efficacy has not yet been fully proven. METHODS: In the current longitudinal observational study, 98 participants with idiopathic PD underwent twice-weekly BT sessions. Primary outcome was self-reported falls per month; secondary outcomes were quantitative and semi-quantitative gait and balance performance evaluations. Statistical methods included segmented generalized estimating equation with an independent correlation structure, binomial distribution, and log link. RESULTS: The average number of self-reported falls per month per participant decreased by 87%, from 0.86 ± 3.58 prior to BT, to 0.11 ± 0.26 during BT. During the lockdown imposed by COVID-19, this increased to 0.26 ± 0.48 falls per month. Females and those > 65 years old reported the greatest increase in falls during the lockdown period. Post-lockdown resumption of BT resulted in another decline in falls, to 0.14 ± 0.33. Quantitative performance metrics, including standing from a seated position and standing on one leg, largely mirrored the pattern of falls pre-and post-lockdown. CONCLUSIONS: BT may be an effective option for many PD patients.


Subject(s)
Boxing , COVID-19/prevention & control , Communicable Disease Control , Exercise Therapy , Parkinson Disease/psychology , Parkinson Disease/therapy , Accidental Falls/prevention & control , Adult , Aged , Aged, 80 and over , COVID-19/epidemiology , Female , Gait , Humans , Longitudinal Studies , Male , Middle Aged , Postural Balance
10.
J Parkinsons Dis ; 11(3): 1047-1056, 2021.
Article in English | MEDLINE | ID: covidwho-1350243

ABSTRACT

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has negatively affected the mental health of the general population. OBJECTIVE: We investigated the determinants of quality of life (QOL) in Parkinson's disease (PD) patients during the COVID-19 pandemic. METHODS: Impacts of lifestyle changes due to the COVID-19 pandemic on 100 patients with PD and their caregivers/spouses were assessed. The Hospital Anxiety and Depression Scale was used to assess anxiety and depression. The physical component summary (PCS) and mental component summary (MCS) scores of the short form (SF)-8 were used to evaluate health-related QOL. RESULTS: Regarding health-related QOL, physical function, role physical, general health, vitality and the PCS score were significantly worse in PD patients than in caregivers. Worsening of PD-related symptoms, increased stress, and decreased physical activity were observed in 29.0%, 37.0% and 44.0% of PD patients, respectively. Sixteen patients (16.0%) experienced problems with hospital access, but none reported medication shortages. Strong concerns about COVID-19 were reported by 47.0% of caregivers and 50.0% of PD patients. In PD patients, increased gait disturbance and rigidity, disease severity, smoking, the levodopa equivalent dose and decreased body weight predicted a worse PCS score; anxiety, depression, female sex, stress and long disease duration predicted a worse MCS score. In caregivers, age and smoking contributed to a worse PCS score; depression, stress and worsening patient mood contributed to a worse MCS score. CONCLUSION: We report the negative impacts of the COVID-19 pandemic on health-related QOL and its determinants in PD patients and their caregivers.


Subject(s)
COVID-19 , Caregivers/psychology , Parkinson Disease/psychology , Quality of Life/psychology , Spouses/psychology , Aged , Anxiety/psychology , Depression/psychology , Exercise/psychology , Female , Health Services Accessibility , Health Surveys , Humans , Japan , Male , Middle Aged , Parkinson Disease/nursing , Parkinson Disease/physiopathology , Sex Factors , Stress, Psychological/psychology , Time Factors
11.
BMC Neurol ; 21(1): 284, 2021 Jul 20.
Article in English | MEDLINE | ID: covidwho-1319459

ABSTRACT

BACKGROUND: The purpose of this study was to describe the effects of COVID-19 social distancing on the function, health, and well-being of people with Parkinson disease (PD), and test the association of these effects with patients' activation levels, i.e., their skills and confidence in managing their health. METHODS: Community-dwelling individuals with PD answered an anonymous web-based survey. Part 1 included 27 multiple-choice questions regarding changes in function, health, medical care, and well-being. Part 2 consisted of the Patient Activation Measure, which enquired about skills and confidence in managing one's health. RESULTS: Respondents (N = 142) reported decreases in various function (24.8%-37.3%), health (33.8%-43%), and well-being (26.1%-47.1%) domains. Rehabilitation ceased for 61.2%. Among those reporting a worsening of health, 67.8% associated this with the cessation of rehabilitative treatments or decrease in physical activity. Patients' activation levels were inversely correlated with increased assistance for activities of daily living, increased tiredness, worsening symptoms, and lack of support from family and friends. CONCLUSIONS: Social distancing had a major negative impact on the health and function of people with PD. PRACTICAL IMPLICATIONS: Supporting people with PD skills and confidence in managing health may preserve their physical and mental health during this period of dramatic changes in life's circumstances.


Subject(s)
COVID-19/psychology , Mental Health , Parkinson Disease/psychology , Physical Distancing , Self-Management/psychology , Activities of Daily Living/psychology , Adult , Aged , COVID-19/epidemiology , COVID-19/prevention & control , Cross-Sectional Studies , Exercise/physiology , Exercise/psychology , Female , Health Behavior/physiology , Humans , Male , Middle Aged , Parkinson Disease/epidemiology , Parkinson Disease/therapy , Self-Management/methods , Surveys and Questionnaires
12.
Parkinsonism Relat Disord ; 89: 128-133, 2021 08.
Article in English | MEDLINE | ID: covidwho-1320182

ABSTRACT

BACKGROUND: In 2020 the coronavirus disease 19 (COVID-19) pandemic imposed a total and sudden lockdown. We aimed to investigate the consequences of the first COVID-19 lockdown (mid-March - mid-April 2020) on motor and non-motor symptoms (NMS) in a cohort of French people with Parkinson's disease (PwP). METHODS: PwP were enrolled either by an on-line survey sent from the national France Parkinson association (FP) to reach the French community of PwP or as part of outpatients' telemedicine visits followed by an hospital-based Parkinson Expert Center (PEC). All patients were evaluated using the same standardized questionnaire assessing motor and NMS (including a list of most disabling, new or worsened symptoms and Patient's Global Impression-Improvement scales [PGI-I]) psycho-social queries and quality of life. RESULTS: 2653 PwP were included: 441 (16.6%) in the PEC group and 2122 (83.4%) in the community-based group. Physiotherapy was interrupted among 88.6% of the patients. 40.9% referred a clinical modification of their symptoms. Based on the questionnaire, pain (9.3%), rigidity (9.1%) and tremor (8.5%) were the three most frequently new or worsened reported symptoms. Based on the PGI-I, the motor symptoms were the most affected domain, followed by pain and psychic state. PwP in community-based group tended to have more frequent worsening for motor symptoms, motor complications, pain and confusion than those of the PEC group. CONCLUSIONS: The first COVID-19 lockdown had a negative impact on motor and NMS of PwP. Efforts should be allocated to avoid interruption of care, including physiotherapy and physical activities and implement telemedicine. .


Subject(s)
COVID-19 , Pandemics , Parkinson Disease/therapy , Cohort Studies , Communicable Disease Control , France , Humans , Muscle Rigidity/epidemiology , Pain/epidemiology , Parkinson Disease/psychology , Physical Therapy Modalities , Quality of Life , Quarantine/psychology , Remote Consultation , Surveys and Questionnaires , Telemedicine , Tremor/epidemiology
13.
Parkinsonism Relat Disord ; 86: 135-138, 2021 05.
Article in English | MEDLINE | ID: covidwho-1230072

ABSTRACT

The evaluation and management of patients with movement disorders has evolved considerably due to the COVID-19 pandemic, including the assessment of candidates for deep brain stimulation (DBS) therapy. Members of the Neuropsychology Focus Group from the Parkinson Study Group Functional Neurosurgical Working Group met virtually to discuss current practices and solutions, build consensus, and to inform the DBS team and community regarding the complexities of performing DBS neuropsychological evaluations during COVID-19. It is our viewpoint that the practice of neuropsychology has adapted successfully to provide tele-neuropsychological pre-DBS evaluations during the global pandemic, thus permanently changing the landscape of neuropsychological services.


Subject(s)
COVID-19 , Deep Brain Stimulation/trends , Movement Disorders/psychology , Movement Disorders/surgery , Neuropsychological Tests , Neuropsychology/trends , Neurosurgery/trends , Pandemics , Parkinson Disease/psychology , Parkinson Disease/surgery , Deep Brain Stimulation/statistics & numerical data , Humans , Telemedicine
15.
Int J Rehabil Res ; 44(2): 173-176, 2021 06 01.
Article in English | MEDLINE | ID: covidwho-1114909

ABSTRACT

The coronavirus disease 2019 pandemic has yielded containment measures with detrimental effects on the physical and mental health of the general population. The impacts of lockdown on clinical features in Parkinson's disease are not well known. We aimed to compare the physical activity, anxiety-depression levels between Parkinson's disease patients and controls during lockdown. Forty-five Parkinson's disease patients and 43 controls were evaluated with the Physical Activity Scale for the Elderly (PASE) and Hospital Anxiety and Depression Scale (HADS) via telephone interview. The patients' disease-related symptoms were worsened during lockdown though regular Parkinson's disease medication use. The PASE scores were low in both groups. The HADS scores of groups were below the cutoff point of anxiety-depression presence. Pandemic restrictions could lead to worsening of the motor and nonmotor symptoms in Parkinson's disease.


Subject(s)
Anxiety/psychology , COVID-19/epidemiology , Depression/psychology , Exercise/psychology , Parkinson Disease/psychology , Aged , Anxiety/etiology , Case-Control Studies , Depression/etiology , Female , Humans , Male , Middle Aged , Pandemics , Surveys and Questionnaires
16.
Rev Neurol (Paris) ; 177(3): 272-274, 2021 Mar.
Article in English | MEDLINE | ID: covidwho-1078106

ABSTRACT

BACKGROUND: Governments around the world have imposed varied containment measures to curb the spread of the COVID-19 infection. The psychological impact could be highly negative in patients with neurologic condition like Parkinson's Disease (PD). METHODS: We prospectively evaluated symptoms of depression and anxiety in 50 (26 females; mean age at 60.4) non demented Moroccan PD patients, using Hospital Anxiety and Depression Scale (HADS), at the beginning and after 6 weeks of a full confinement. RESULTS: At the first evaluation, 28% of patients had depression while 32% had anxiety. After 6 weeks of confinement, some patients got worse and others got better scores but no significant statistical difference for both troubles was seen. CONCLUSION: Our results show that there is no significant impact of 6 weeks of confinement on overall anxiety and depression scores. However, confinement could have an unexpected positive psychological impact on a significant number of PD patients.


Subject(s)
Anxiety/epidemiology , COVID-19/epidemiology , Depression/epidemiology , Pandemics , Parkinson Disease/epidemiology , Quarantine/psychology , Aged , COVID-19/psychology , Female , Humans , Male , Middle Aged , Morocco/epidemiology , Parkinson Disease/complications , Parkinson Disease/psychology , SARS-CoV-2/physiology , Stress, Psychological/epidemiology , Stress, Psychological/psychology , Surveys and Questionnaires
17.
J Parkinsons Dis ; 11(2): 491-495, 2021.
Article in English | MEDLINE | ID: covidwho-1034835

ABSTRACT

People with Parkinson's disease (PwP) have been suggested to be more vulnerable to negative psychological and psycho-social effects of the COVID-19 pandemic. Our aim was to assess the potential impact of the COVID-19 pandemic in PwP. A Danish/Swedish cohort of 67 PwP was analysed. Health-related quality of life (HRQL), depression, anxiety, apathy, sleep and motor symptom-scores were included in the analysis. Additionally, the Danish participants provided free-text descriptions of life during the pandemic. Overall, the participants reported significantly better HRQL during the COVID-19 period compared with before. Reduced social pressure may be part of the explanation. Despite worsened anxiety, night sleep improved.


Subject(s)
COVID-19/epidemiology , COVID-19/psychology , Parkinson Disease/epidemiology , Parkinson Disease/psychology , Quality of Life/psychology , Adult , Aged , Aged, 80 and over , Anxiety/diagnosis , Anxiety/epidemiology , Anxiety/psychology , COVID-19/diagnosis , Cohort Studies , Denmark/epidemiology , Humans , Middle Aged , Pandemics , Parkinson Disease/diagnosis , Sweden/epidemiology
19.
Sleep Med ; 77: 15-22, 2021 01.
Article in English | MEDLINE | ID: covidwho-939269

ABSTRACT

BACKGROUND: Literature shows that home confinement during coronavirus disease 2019 (COVID-19) pandemic has significantly affected sleep. However, such information regarding subjects having Parkinson's disease (PD) is unavailable. METHODS: This cross-sectional study was conducted using a questionnaire, developed and validated by experts. PD subjects from nine centers across India were included. Questionnaire assessed presence as well as change in sleep-related parameters and PD symptoms during home confinement. Restless legs syndrome (RLS) and REM sleep behavior disorder (REMBD) was diagnosed using validated questionnaire. Additionally, changes in physical activity, adoption of new hobbies during home confinement and perceived quality of life were assessed. RESULTS: Of 832 subjects, 35.4% reported sleep disturbances. New-onset/worsening of sleep disturbances (NOWS) was reported by 23.9% subjects. Among those with sleep disturbances (n = 295), insomnia symptoms worsened in half (51.5%) and nearly one-fourth reported worsening of RLS (24.7%) and REMBD (22.7%) each. NOWS was common in subjects lacking adequate family support during home confinement (P = 0.03); home confinement > 60 days (P = 0.05) and duration of PD > 7 years (P = 0.008). Contrarily, physical activity >1 h/day and engagement in new hobbies during home confinement were associated with better sleep. NOWS was associated with worsening of motor as well as non-motor symptoms of PD (P < 0.001) and poorer life quality (P < 0.001). CONCLUSION: Home confinement during COVID-19 pandemic was significantly associated with NOWS among PD subjects. NOWS was associated with global worsening of PD symptoms and poorer life quality. Physical activity >1 h/day and adoption of new hobbies during home confinement were associated with better sleep.


Subject(s)
COVID-19/epidemiology , Parkinson Disease/epidemiology , Quality of Life/psychology , Restless Legs Syndrome/epidemiology , Sleep Wake Disorders/epidemiology , COVID-19/psychology , Comorbidity , Cross-Sectional Studies , Disease Progression , Female , Humans , India , Male , Parkinson Disease/psychology , Restless Legs Syndrome/psychology , Sleep Wake Disorders/psychology , Surveys and Questionnaires
20.
Parkinsonism Relat Disord ; 80: 148-151, 2020 11.
Article in English | MEDLINE | ID: covidwho-786184

ABSTRACT

INTRODUCTION: The coronavirus disease 2019 (COVID-19) pandemic has disrupted everyday life of Parkinson's disease (PD) patients, but its clinical impact has not been illustrated. In this study, we investigated the change in physical activity and subsequently clinical symptoms of PD during the COVID-19 pandemic. METHODS: We enrolled PD patients who were able to ambulate independently and had visited our clinic at Samsung Medical Centre from December 2019 to January 2020 (baseline) and in May 2020 (follow-up during the COVID-19 crisis), and divided them into either 'the sustained exercise group' or 'the reduced exercise group'. Then, we assessed the change in the exercise and clinical features between these two groups over the study period. RESULTS: A total of 100 subjects were recruited. During the COVID-19 pandemic, the amount, duration and frequency of exercise were reduced. There was decrease in number of patients who do indoor-solo exercise and increase in that of patients who do not exercise. One third reported subjective worsening of both motor and non-motor features, although Unified PD Rating Scale (UPDRS) part 3 score was similar. Additionally, the reduced exercise group reported more motor and non-motor aggravation than the sustained exercise group, despite lack of significant difference in the UPDRS part 3 score. CONCLUSION: The COVID-19 pandemic had a clear impact on exercise and subjective symptoms in PD patients, with reduced exercise being related to a subjective increase in both motor and non-motor symptoms of PD. Maintaining exercise should therefore be emphasized even in situations like the COVID-19 pandemic.


Subject(s)
COVID-19/epidemiology , Exercise Therapy/trends , Exercise/physiology , Parkinson Disease/epidemiology , Parkinson Disease/therapy , Aged , Exercise/psychology , Female , Humans , Male , Middle Aged , Pandemics , Parkinson Disease/psychology , Quality of Life/psychology
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