World Parkinson's Day 2021: Mental Health For Parkinson's Patients And Their Caregivers During Covid-19 Pandemic

In terms of prevalence, Parkinson's disease (PD) is the second most common neurodegenerative disorder worldwide. PD has a variable prevalence in India as reported in different studies. The prevalence can be as high as 325 cases/100,000 to as low as 16 cases/100,000 in different studies. This variation in prevalence could reflect variable genetic make-up and risk factors. There is also a male predominance as compared to females with a possible protective role of female sex hormones. PD commonly presents with symptoms of tremor, rigidity, slowness or bradykinesia, speech issues, and balance and walking issues. In addition, PD patients suffer from several non-motor problems like constipation, pain, sleep disorders, mood disorders, depression and anxiety. Mental health is of paramount importance in a person suffering from PD. A positive mindset helps to fight this disease better by enhancing the right coping mechanisms, which are inbuilt in our brain.

The multitude of challenges being faced due to covid-19 pandemic act as stress factors that negatively impact the mental and emotional health of every PD patient. The lack of exercise, limited social interaction with their loved ones and the fear of covid-19 infection has triggered neuropsychiatric and cognitive issues like anxiety and depression. Also, in a recent study by Dhamija et. al. published in Annals of Indian Academy of Neurology, it was found that almost 40.6% patients reported symptomatic worsening during the lockdown period. Both the motor symptoms like tremor and rigidity/stiffness, and the neuropsychiatric issues discussed above were worse during lockdown in PD patients. A home based physiotherapy program may help to improve several of these quality of life parameters.

As caregivers (either as a treating doctor or a family member) we need to address these issues with compassion and positivity. They may need psychiatric care and support with early referrals. In some cases, PD patients needs psychiatry, neuro-rehabilitation, neuro-psychology, speech and occupation therapist.

We are living in difficult times and so are our PD patients. A helping, caring hand and smiling face will infuse positivity and zeal to fight with Parkinson's disease in these patients during this difficult time of covid-19 pandemic.

(Dr. Vikash Agarwal is a Senior consultant - Neurologist and In-charge Comprehensive Parkinson's Disease Clinic (CPDC), Gleneagles Global Health City, Chennai)

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