González David Andrés, Tosin Michelle H S, Warner-Rosen Tila, Afshari Mitra, Barton Brandon, Fleisher Jori E, Hall Deborah A, Kirby Alana E, Kompoliti Katie, Mahajan Abhimanyu, Patel Neepa, Swan Christina, Goetz Christopher G
Department of Neurological Sciences, Rush University Medical Center, USA.
Department of Neurological Sciences, Rush University Medical Center, USA.
Parkinsonism Relat Disord. 2025 Jul;136:107867. doi: 10.1016/j.parkreldis.2025.107867. Epub 2025 May 10.
Loneliness is linked to poor life quality and health, but its relevance in Parkinson's disease (PD) is incompletely understood. The current study aimed to understand rates of loneliness and its determinants in PD.
Consecutive cross-sectional sampling resulted in 178 PD subjects (60 % men) across disease stages (86 % early-stage) with gold-standard diagnoses. Loneliness was characterized with two scales, PD was characterized by objective measures, motor ratings, and perceived functional impact, and social-emotional assessment included social connection, depression, and life space. Nonparametric bivariate and robust multivariate regression determined predictors of loneliness in PD, and social-emotional predictors of PD functional impact.
Most participants had concern, with 64.6 % endorsing high levels of loneliness. PD stage, but not motor impairment or other objective measures, predicted loneliness. In contrast, subjective measures of PD functional impact, social network size, social support, depression, and life space had a significant relationship with loneliness. In multivariate models, depression, PD functional impact, and social network size specifically emerged as the most important predictors of loneliness. Although social loneliness was generally more impacted by PD, men had more emotional loneliness. Similarly, loneliness was a potent, independent predictor of PD functional impact.
We show that loneliness is a critical issue in PD which relates more to individual response to disease than objective motor severity. Although PD most impacts general relationships' quality, men may have additional loss of intimate confidantes. Interventions targeting depression and social networks may not only improve loneliness but also improve PD functional impact.
孤独与生活质量低下和健康状况不佳有关，但其在帕金森病（PD）中的相关性尚未完全明确。本研究旨在了解PD患者的孤独发生率及其决定因素。
采用连续横断面抽样法，纳入178例经金标准诊断的各疾病阶段的PD患者（60%为男性），其中86%为早期患者。采用两种量表对孤独进行评估，通过客观测量、运动评分和感知功能影响对PD进行评估，社会情感评估包括社会联系、抑郁和生活空间。采用非参数双变量和稳健多变量回归分析确定PD患者孤独的预测因素以及PD功能影响的社会情感预测因素。
大多数参与者存在担忧，64.6%的人表示孤独程度较高。PD分期可预测孤独感，而运动障碍或其他客观指标则不能。相比之下，PD功能影响的主观指标、社交网络规模、社会支持、抑郁和生活空间与孤独感显著相关。在多变量模型中，抑郁、PD功能影响和社交网络规模是孤独感最重要的预测因素。虽然社交孤独感通常受PD影响更大，但男性的情感孤独感更强。同样，孤独是PD功能影响的一个有力的独立预测因素。
我们发现孤独是PD中的一个关键问题，它与个体对疾病的反应关系更大，而非客观的运动严重程度。虽然PD对一般人际关系质量影响最大，但男性可能会额外失去亲密知己。针对抑郁和社交网络的干预措施不仅可以改善孤独感，还可以改善PD功能影响。
