The recent trend in medicine of moving towards a more comprehensive, holistic, and patient-centric care model, including the psychosocial aspects of living with chronic disease, has led to the proliferation of multidisciplinary teams. In the case of Parkinson’s, the many aspects of the condition make this approach essential.
Indu Subramanian, MD, director, Southwest Parkinson’s Disease Research, Education and Clinical Centers, who, other than being a trained movement disorder neurologist also specializes in wellness and integrative medicine approaches, published the results of a survey study of more than 1500 patients with idiopathic Parkinson’s from the CAM Care PD study. These results revealed that loneliness may have a great impact on the severity of the disease.
The author of the article explains that with social connection being a known basic human need, social isolation remains a huge problem amongst the elderly and people with Parkinson’s. With the COVID-19 pandemic came the fear of contagion, and social distancing rules have exacerbated social isolation for these vulnerable and often frail people. But other than social isolation, which can be objectively measured, there is also the related concept of loneliness. Loneliness has been described as “an undesirable subjective emotional state in which there is a perception of social isolation, or the felt experience of being lonely” or “the dissatisfaction with the discrepancy between desired and actual social relationships.” It is related to “unfulfilled intimate and social needs.”
There are three dimensions of loneliness:
- intimate, or emotional: the yearning for a close confidant or emotional partner,
- relational, or social: the longing for close friendships and social companionship, and
- collective: the need for a network or community of people who share one’s sense of purpose and interests.
Loneliness can be felt if any one of these dimensions is not satisfied, so it is possible, for example, to be happily married and still feel lonely.
Individuals rated their overall quality of life (QoL) on a 1–5 scale. The higher the QoL score, the more likely the participant was to say they had a lot of friends, and the lower the QoL score, the more likely they were to report feeling lonely. Tremor is one of the most obvious and recognized hallmarks of PD and can be a source of social stigma for many patients with PD. Remarkably, QoL was less associated with patient-reported tremor intensity than it was associated with number of reported friends and the subjective perception of being lonely.
In their conclusion, the authors recommend that the healthcare system offer social prescribing or a prescription for social engagement.
An emphasis on social activities combined with a physical exercise component is preferable because of the additional benefits of physical exercise. Moreover, the social element is more likely to make the activity enjoyable and thus ensure optimal adherence, as well as the flip side of peer pressure making the participant feel uncomfortable for not showing up.
Source: Subramanian, Indu, Joshua Farahnik, and Laurie K. Mischley. "Synergy of pandemics-social isolation is associated with worsened Parkinson's severity and quality of life." npj Parkinson's Disease 6, no. 1 (2020): 1-8.
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