Background
The COVID19 pandemic turned the world as we know it upside down, with most countries imposing national lockdowns. COVID19 is caused by a new virus and results in symptoms such as high temperature, a continuous cough and loss of smell and taste and has infected more than 37.7 million people worldwide. It is known to cause worse symptoms in the elderly and clinically vulnerable, leaving them at higher risk of hospitalisation. In the majority of cases, Parkinson’s is an age-associated condition, therefore people with Parkinson’s (PwP) are at higher risk of developing COVID19 complications.
Parkinson’s causes an array of symptoms that differ between individuals. All PwP will experience at least two of the classical motor symptoms (resting tremor, slowed movement, rigidity), however there are also many non-motor symptoms such as depression, anxiety and sleep problems to name a few. The non-motor symptoms experienced by PwP are different between individuals, meaning that no two PwP will have the same experience.
Why is the study important?
Previous studies have shown that stress can impact the motor and non-motor symptoms of Parkinson’s. The authors were interested to understand what the impact of the unprecedented national lockdowns had on PwP and also the perceptions of the primary care givers.
What did the authors do and how did they do it?
This study was undertaken at one centre in India and information was collected between June and September 2020. The lockdown period in India was 24th March 2020 until 31st May 2020. 64 PwP and 64 primary care givers took part in this study which involved answering a questionnaire via telephone. The questionnaire can be viewed in full at the link to the study but included questions regarding the worsening of motor and non-motor symptoms such as tremor, sleeping issues and walking speed.
What are the results?
26 of the 64 PwP reported a worsening in motor symptoms, with the most common complaint being resting tremors. The average time for the worsening of symptoms was 8 weeks after the start of lockdown. 11 of the 26 PwP that reported worse motor symptoms also reported an increase in low mood, anxiety and sadness, again approximately 8 weeks after lockdown initiation.
From the 64 caregivers interviewed, 26 reported worsening of symptoms in PwP. The paper doesn’t mention whether these are the caregivers of the 26 PwP referred to above. The caregivers reported worsening in the same motor and non-motor symptoms as the PwP.
What do the findings mean going forward for people with the disease?
The COVID19 pandemic has caused much undue stress upon many people. The way that we live our lives has dramatically changed in the last 18 months and although it is important to understand the disease itself, it is also important to understand the effect it has had on people with long term illnesses, such as Parkinson’s. This study is an important step in understanding what impact COVID19 has had on PwP, however it should be interpreted with caution as it is only a small snapshot from one location in India. It is possible that their findings are mirrored across the globe however this will need to be investigated in other Parkinson’s populations to validate these findings. Results from this study, and any further studies investigating the effect of the COVID19 pandemic on PwP, could be used to better understand the needs of those with Parkinson’s in situations of high stress and potentially impact the handling of future pandemics.
Overall this study may act to reassure other PwP that they are not alone if they have experienced a worsening of symptoms during periods of national lockdown and isolation due to the stress and uncertainty that it caused.