Stressors of COVID-19 are associated with worse mental health and poorer quality of life (QOL) in patients with Parkinson disease (PD), according to study results presented at the International Congress of Parkinson’s Disease and Movement Disorders (MDS) Virtual Congress 2021, held from September 17 to 22, 2021.

Patients with PD may be more vulnerable to experiencing distress due to, for example, limited physical activity, which can lead to a worsening of symptoms, according to the authors of the current study. Moreover, during the COVID-19 pandemic, the drastic changes introduced to daily routines may have also contributed to the distress in patients with PD.

The researchers of the sought to identify potential differences in subgroups of PD regarding the effects of COVID-19 stressors to better tailor care for this patient population.

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The cross-sectional study used baseline data from the PRIME-NL study. Researchers grouped 8 COVID-19 stressors into care stressors, social stressors, and a stressors sum score.

The Beck Depression Inventory (BDI) was used to assess depression, the Spielberger State-Trait Anxiety Inventory (STAI) to measure anxiety, and the Parkinson’s Disease Quality of Life Questionnaire (PDQ-39) to evaluate QOL. Outcomes were standardized, and the models were adjusted for sex, age, years since diagnosis, comorbidities, education, living situation, and region. Stratification was conducted for demographics and disease-related and coping characteristics.

A total of 833 participants (mean age, 70.2±7.9 years; 38.1% women) were included in the study. A higher COVID-19 stressors sum score was associated with worse depression (BDI beta, 0.03; 95% CI, 0.02-0.05), greater anxiety (STAI beta, 0.04; 95% CI, 0.02-0.05), and poorer QOL (PDQ-39 beta, 0.03; 95% CI, 0.02-0.04).

The effects were found for multiple subgroups but were more significant in women, younger patients, and those with higher education, a longer disease duration, and a higher MDS-Unified Parkinson’s Disease Rating Scale-II score. Strata that were elevated in confrontive coping and planful problem solving had smaller associations.

A hypothetical intervention that omitted all 8 COVID-19 stressors was associated with a decrease in BDI from 11.2 (95% CI, 10.7-11.6) to 9.0 (95% CI, 8.2-9.8), STAI from 74.3 (95% CI, 73.1-75.6) to 68.0 (95% CI, 65.4-70.5), and PDQ-39 from 25.1 (95% CI, 24.2-26.0) to 20.9 (95% CI, 19.3-22.6).

“Our results suggest that confrontive and planful problem-solving coping strategies are beneficial,” the study authors stated. “COVID-19 stressors are important targets for tailored interventions to improve mental health in people with [PD] during the COVID-19 pandemic.”


Dommershuijsen L, Heide A, Berg E, et al. Targeted hypothetical interventions on COVID-19 stressors in people with Parkinson’s disease. Presented at: MDS Virtual Congress 2021; September 17-22, 2021. Abstract 1045.