Cosentino Marco, Pinoli Monica, Uslenghi Margherita, Pennisi Mario, Maldacea Giulio, Comi Cristoforo, Marino Franca
Center for Research in Medical Pharmacology, University of Insubria, Varese, Italy.
Associazione Parkinson Insubria-As.P.I, Varese, Italy.
Aging Ment Health. 2025 Feb;29(2):299-306. doi: 10.1080/13607863.2024.2388770. Epub 2024 Aug 8.
COVID-19 lockdowns were introduced to control the pandemic, however, they resulted in a global disruption of daily life and of individual and global health. Reduced accessibility of health services, unavailability of food and drugs, and mental health challenges had a huge impact on older people and on people living with disabling conditions such as Parkinson's disease (PD). We assessed whether and to what extent the more disabled and vulnerable people with Parkinson's (PwP) were affected by lockdowns.
We analysed responses collected through a web-based survey of PwP according to their self-sufficiency [self-sufficient (SS); nearly self-sufficient (nSS); non-self-sufficient, cared for by family (NSS/F); non-self-sufficient, needs professional care (NSS/PC)].
Fears due to COVID-19 and difficulties with food supply were highest in NSS/F PwP. Difficulties with the supply of Parkinson's medication or other drugs were apparently not an issue, while problems accessing primary care physicians and neurologists were similar across all patient groups. On the contrary, difficulties with daily and motor activities were higher in NSS/F and NSS/PC PwP. PwP symptoms worsened in all groups, with NSS/F and NSS/PC participants experiencing the worst deterioration. Notably, the deterioration of PwP symptoms was specifically related to changes in daily and motor activities, with participants who reported less engagement in daily and motor activities experiencing the worst deterioration.
Findings strongly support the need for decision-makers and healthcare providers to carefully re-evaluate the risk-benefit ratio of limiting healthcare accessibility for PwP, since evidence shows that lockdown measures primarily impact the groups who are most fragile and vulnerable.
实施新冠疫情封锁措施是为了控制疫情大流行，然而，这些措施导致了日常生活以及个人和全球健康受到全球性干扰。医疗服务可及性降低、食品和药品供应短缺以及心理健康挑战对老年人以及患有帕金森病（PD）等致残性疾病的人群产生了巨大影响。我们评估了残疾程度更高且更为脆弱的帕金森病患者（PwP）受封锁措施影响的情况以及影响程度。
我们根据PwP的自给自足程度[自给自足（SS）；接近自给自足（nSS）；非自给自足，由家人照顾（NSS/F）；非自给自足，需要专业护理（NSS/PC）]，分析了通过基于网络的PwP调查收集到的回复。
NSS/F组的PwP因新冠疫情产生的恐惧以及食品供应困难最为严重。帕金森病药物或其他药物供应方面的困难显然不是问题，而所有患者组在联系初级保健医生和神经科医生方面遇到的问题相似。相反，NSS/F组和NSS/PC组的PwP在日常和运动活动方面遇到的困难更大。所有组的PwP症状均有所恶化，NSS/F组和NSS/PC组的参与者症状恶化最为严重。值得注意的是，PwP症状的恶化与日常和运动活动的变化具体相关，报告较少参与日常和运动活动的参与者症状恶化最为严重。
研究结果有力支持决策者和医疗服务提供者有必要仔细重新评估限制PwP获得医疗服务的风险效益比，因为有证据表明封锁措施主要影响的是最脆弱的群体。
