Psychiatric Symptoms Show Link with Parkinson’s Social Functioning

Researchers utilized a new metric called the Parkinson's Disease Social Functioning Scale

Marisa Wexler, MS avatar

by Marisa Wexler, MS |

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A new metric called the Parkinson’s Disease Social Functioning Scale (PDSFS) can measure social functioning in people with Parkinson’s disease, a new study reports.

PDSFS scores show associations with the severity of psychiatric symptoms, suggesting better treatment of symptoms could improve patients’ ability to function in social settings, researchers said in their study, “Investigating the interaction between neuropsychiatry features and daily activities on social function in patients with Parkinson’s disease with mild cognitive impairment,” which was published in BJPsych Open.

Social function describes a person’s ability to engage constructively with other people and in society. Parkinson’s symptoms can cause problems with social interaction and some patients have these difficulties years before their motor symptoms appear, but this has generally not been researched.

Scientists in Taiwan constructed the PDSFS to measure Parkinson’s patients’ social functioning. The scale assesses several components, including family life, self-care, hobbies, interpersonal relationships, and social bonds.

In this study, the researchers wanted to see whether PDSFS scores are associated with cognitive status with Parkinson’s disease.

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Social functioning and cognitive disorders assessed

The study included 181 adults with Parkinson’s disease, as well as 121 older adults without any known disorders who served as controls. Based on scores on the Mini-Mental State Examination (MMSE) — a standard measure of cognitive function — 55 Parkinson’s patients had mild cognitive impairment (MCI), an early stage of cognitive difficulty that often precedes dementia.

After accounting for differences in sex, age, and education, average PDSFS scores were lowest among Parkinson’s patients with MCI, who scored particularly poorly on family life, hobbies, and self-care, “in taking medicine, handling finances, and managing transportation,” the researchers wrote.

Patients with no cognitive impairment generally showed comparable social functioning to healthy older adults, though the researchers noted they often scored low in domains related to social bonds. This suggest that many with Parkinson’s experience isolation and loneliness that aren’t related to cognitive problems.

“Although the overall social functioning of the [Parkinson’s disease without cognitive impairment] group is not different from that of healthy older adults, the impairment of ‘social bond’ cannot be ignored. Social isolation and loneliness are harmful,” they wrote.

PDSFS scores strongly correlated with other standardized measures like the MMSE, the Activities of Daily Living Scale, and the Neuropsychiatric Inventory. However, they were not significantly linked with demographics or measures of Parkinson’s severity.

“Our findings suggest that general cognitive function, activities of daily living, and neuropsychiatric symptoms are significantly related to social functioning, whereas demographic and disease severity variables are not,” the researchers wrote, noting the results imply that “improving neuropsychiatric symptoms” may aid patients’ social functioning. Promoting engagement with daily activities may also be helpful, they said.

Additional analyses showed that, at a cutoff score of 53, the PDSFS could differentiate between Parkinson’s patients with or without mild cognitive impairment. The sensitivity (true-positive rate) was 80% and the specificity (true-negative rate) was 53.4%.

This low specificity value means most patients with mild cognitive impairment scored below the cutoff, but many without apparent cognitive impairment also scored below it.

“Based on our findings, the optimal cut-off score of the PDSFS for [mild cognitive impairment in Parkinson’s disease] was 53 and had acceptable discrimination,” the researchers wrote, noting that the reason for the low specificity was because, while those with cognitive impairment tended to have lower PDSFS scores, they didn’t show severe problems with social function, making the difference between the groups very subtle and difficult to distinguish.

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