Objective: To examine how depression and gait influence social engagement in parkinsonism.

Background: Depression significantly affects quality of life in parkinsonism^. Yet, the interplay of social network, perceived support, loneliness, and life-space mobility with gait and cognition in depression is unclear. This study aims to examine these relationships to inform targeted interventions.

Method: This cross-sectional study analyzed 1360 individuals with parkinsonism from the Rush Alzheimer’s Disease Center database, identified by parkinsonian summary score, diagnosis, bradykinesia score, and number of parkinsonian signs. Social engagement measures were network size, perceived support, loneliness (social isolation), and life-space mobility. Multivariate least square regression models estimated standardized beta coefficients to assess the association of depression and social engagement, after adjusting for key clinical covariates. Comparative regression tested differential impacts of cognition and depression and ranked depression predictors by standardized beta coefficients. Structural equation modeling examined the influence of gait on social engagement across depression levels.

Results: Loneliness was most associated with depression (β = 0.39, p < 0.01). Reduced life-space mobility showed a weaker link to higher depression (β = -0.09, p < 0.01) [Fig.1]. Gait impairment’s effect on social engagement varied by depression levels, with the most reduction in perceived social support in those with low depression (β = 0.007, p <0.01). There was no significant impact on social network size (p = 0.49) or life-space mobility (p = 0.74) [Fig.2]. Depression was a stronger predictor of loneliness (β = 0.37, p < 0.01), while cognition was strongly linked to life-space mobility (β = 0.26, p < 0.01) [Fig.3]. A gradient plot of standardized coefficients confirmed loneliness and gait to be the strongest predictors of depression (p < 0.01) [Fig 4].

Conclusion: Loneliness is a key predictor of depression in parkinsonism, emphasizing the need for social engagement initiatives. Gait also limits social engagement. Those with low depression may be more aware of gait limitations, amplifying the perceived lack of support. Depression correlates more with loneliness, while cognition links to life-space mobility. Future research should examine whether interventions targeting psychosocial and mobility-related challenges reduce depression in parkinsonism.

Effect of Depression on Social Engagement

Interaction Effects of Gait and Depression

Cognition Vs Depression

Predictors of Depression

References: 1. Reijnders, J. S., Ehrt, U., Weber, W. E., Aarsland, D., & Leentjens, A. F. (2008). A systematic review of prevalence studies of depression in Parkinson’s disease. Movement Disorders, 23(2), 183-189.
2. Schrag A, Jahanshahi M, Quinn N: How does Parkinson’s disease affect quality of life? A comparison with quality of life in the general population. Mov Disord. 2000, 15:1112-8. 10.1002/1531-8257(200011)15:6<1112:: AID-MDS1008>3.0.CO;2-A
3. González DA, Tosin MHS, Goetz CG. The plight of loneliness in Parkinson’s disease: New opportunities. Parkinsonism Relat Disord. 2022 Dec;105:145-148. doi: 10.1016/j.parkreldis.2022.10.029. Epub 2022 Oct 28. PMID: 36333238.
4. Prell T, Schönenberg A, Heimrich KG. The impact of loneliness on quality of life in people with Parkinson’s disease: results from the Survey of Health, Ageing and Retirement in Europe. Front Med (Lausanne). 2023 Jun 23;10:1183289. doi: 10.3389/fmed.2023.1183289. PMID: 37425329; PMCID: PMC10326722.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/depression-and-social-engagement-in-community-dwelling-older-adults-with-parkinsonism/