Experts say it’s important for people with Parkinson’s to make social connections.
- Researchers report that loneliness is associated with a higher risk of Parkinson’s disease.
- They note that people with Parkinson’s may worry that their illness will get in the way of friendships.
- They said that is important because friendships add to feelings of well-being.
Researchers report they have found an association between loneliness and Parkinson’s disease.
Their findings were presented in a study published on October 2 in the journal JAMA Neurology.
In their study, the researchers examined more than 491,000 participants with a follow-up period of 15 years.
Researchers said they uncovered the association between loneliness and the risk of Parkinson’s disease independent of depression, genetics, and other prominent risk factors.
In the study, participants were asked, “Do you often feel lonely?” and prompted to answer either “yes” or “no.”
Approximately 18% (91,186 people) indicated they did feel lonely. Those who did report loneliness were slightly younger, more likely to be female, had fewer resources, were less likely to have a college degree, had more health risks — such as smoking and being physically inactive — and had worse overall physical and mental health.
During the 15-year follow-up, 2,822 people in the study developed Parkinson’s disease. The researchers said they used these findings to establish the association between loneliness and Parkinson’s.
What’s the link between loneliness and Parkinson’s?
The researchers noted that their study adds to growing evidence that loneliness substantially impacts health, including neurodegenerative diseases such as Alzheimer’s and other forms of dementia.
“Feelings of loneliness are common in [Parkinson’s] and may result from physical and psychological limitations from the disease,” said Dr. Andrew Feigin, executive director of The Marlene and Paolo Fresco Institute for Parkinson’s and Movement Disorders at NYU Langone Health in New York, who was not involved in the study.
“In addition, loneliness can result in depression resulting in withdrawal, lack of motivation, less activity, and potentially less exercise, all behaviors that may negatively impact [Parkinson’s],” he told Medical News Today.
“This study suggests that the presence of loneliness may, in fact, predate the diagnosis of [Parkinson’s] in some patients and increase the risk of [Parkinson’s}. This study demonstrates an association between loneliness and increased risk of [Parkinson’s} but does not demonstrate cause and effect. It is possible that other unknown factors associated with loneliness are what lead to the increased risk of [Parkinson’s] — the authors acknowledge this in the discussion.”
— Dr. Andrew Feigin, Parkinson’s and movement disorders specialist
Can you reduce the risk of Parkinson’s?
Combating loneliness does not mean reducing the risk of developing Parkinson’s disease.
“This article reports an association between loneliness and the development of Parkinson’s disease,” said Dr. Pietro Mazzoni, a neurologist specializing in treating Parkinson’s at The Ohio State University Wexner Medical Center who was not involved in the study.
“The study’s major strengths are the very large number of participants (nearly half a million) and that its design was longitudinal: a group of people were followed over 15 years and the number of participants who developed [Parkinson’s] in that time period were counted. These features allow researchers to reach far stronger conclusions than most studies that address this type of question,” Dr. Mazzoni told MNT.
“The main finding was that participants who were lonelier at the beginning of the study were more likely to develop [Parkinson’s]. This finding is very interesting. The conclusion was that there is an increased association between loneliness and a subsequent diagnosis of [Parkinson’s]. It is tempting to extend this conclusion to concern that loneliness might increase the risk of developing [Parkinson’s]. This is absolutely not the case. Although the term ‘risk factor’ is commonly used in the field of epidemiology, its meaning is different from its meaning outside the field of epidemiology.”
Dr. Mazzoni clarified that the study found an association between pre-existing loneliness and subsequently being diagnosed with Parkinson’s.
“Loneliness is a marker that predicts the future development of [Parkinson’s],” he added.
How does Parkinson’s disease progress?
According to Mazzoni, there are three things to keep in mind when discussing loneliness and Parkinson’s disease.
Loneliness may not always lead to Parkinson’s
The study recorded Parkinson’s disease as appearing after the beginning of the study. However, Parkinson’s is thought to start in the brain as early as 15 to 20 years before it is diagnosed.
Therefore, it is an open question whether loneliness truly preceded Parkinson’s. If loneliness began after the start of brain changes caused by Parkinson’s, then loneliness cannot cause or increase the risk of Parkinson’s.
Causes of Parkinson’s are multifactorial
The statistical analysis that is the basis of the study’s conclusion, as well-conceived and as powerful as it is, has an important limitation.
The authors accounted for a long list of “covariates,” such as genetic risk factors and physical activity, that could have confounded the results.
The method for “accounting for” or “factoring out” these covariates requires assumptions that are difficult to prove. Given how many factors can potentially increase the risk of Parkinson’s, any conclusion that relies on excluding all these factors must be taken with at least some skepticism.
Reducing loneliness may not affect Parkinson’s risk
As explained above, an association between pre-existing loneliness and Parkinson’s does not mean that reducing loneliness will reduce the risk of developing Parkinson’s in the future.
Of course, loneliness is worth combating for many other reasons. In the case of Parkinson’s, the finding of an association is exciting as it suggests that a better understanding of loneliness and its relationship to brain function might provide useful insights into how Parkinson’s begins.
Importance of social connections
Parkinson’s is a movement disorder that can impede getting together with other people.
Someone may need to wait for someone else for transportation. Someone can feel self-conscious because of tremors. Someone might have safety issues.
“Individuals with Parkinson’s have a higher risk of what in the medical field is called apathy, but I don’t believe that is the correct word,” said Dr. Melita Petrossian, a neurologist and director of the Pacific Movement Disorders Center at Pacific Neuroscience Institute in California who was not involved in the study.
“It’s more they lack the motivation to get themselves up and out and talk to other people,” she explained to MNT.
“While this is common in people with Parkinson’s, the [COVID-19] pandemic worsened it. There were months when people didn’t leave their houses, and while we could connect digitally, it isn’t the same. But some people may have gotten used to being home alone, which took away even more motivation to get up and out.”
“I see people returning to where they were before the pandemic, but it is a slow process. I think it is good for people to have a few people they are very close to, whether family or friend. Then there should be another five or six friends. And then they should have a network of acquaintances. I think that would help for people with Parkinson’s not to be lonely.”
— Dr. Melita Petrossian, neurologist
Tips to minimize loneliness
“We know with confidence that social relationships play an important role in health and well-being across many clinical populations and settings,” said Laura Boxley, PhD, a clinical neuropsychologist in the Department of Psychiatry and Behavioral Health at The Ohio State University Wexner Medical Center who was not involved in the study.
“Modern medical practice now incorporates social determinates of health as an integral framework to better understand risk and plans for care,” she explained to MNT.
“Where you live, who you live with, and how you spend your time are all variables that we recognize as having an impact on health behaviors and outcomes.”
The Endeavor Foundation suggests ways of making friends when you have a disability:
Join a club or community group
Check your area for clubs that integrate your interests with socializing. You can use online resources to locate different groups.
Attend a community event
Check your newspaper and online to find events in your area that interest you, such as concerts, craft fairs, cooking demonstrations, or gardening tours. Start by making a list of your interests and then find out what events fit those interests.
There are so many opportunities to volunteer.
Do you like animals? Consider volunteering at a local shelter. Do you enjoy spending time with children? Contact your local schools to find out if they have a grandparent program you can join. Do you like being around babies?
Many hospitals have volunteer opportunities where you can come and hold and rock infants. You can also look for local charities and nonprofits whose mission fits your personal or career goals.
Enroll in the workshop or adult education course
Is there something you have been wanting to learn? A skill you want to improve? Try a Google search for “workshops and classes near me” to see what comes up in your area.
Reconnect with past friends
Social media makes it possible to locate classmates from colleagues whose company you enjoyed decades ago. Once you find them, you only need to say “hi” and see where the conversation goes.
Be open to saying yes
We know it’s easier to say no and stay home. But that choice keeps you alone.
Commit to say yes.
Maybe start with one yes per month. You might find that you enjoy it once you start getting out there and will look for more opportunities.