Objective: To investigate the relationship between physical proximity within advanced Parkinson’s disease (PD) patient–caregiver dyads and the mobility of each dyad member during daily life.

Background: People with advanced PD experience progressive motor impairments that can negatively affect several aspects of daily life, including mobility and functional independence. Consequently, caregivers often play a key role in supporting patients’ mobility and daily activities. However, little is known about how the physical proximity between patients and caregivers relates to their real-world mobility patterns. Advances in wearable technologies now enable continuous monitoring of both movement and proximity in naturalistic settings, providing new opportunities to investigate dyadic mobility behaviors over extended periods.

Method: Twenty dyads, each comprising a participant with advanced PD (%Female = 41%, Age =69±9 years; Hoehn & Yahr stage = 1:38%, 2:38%, 3:19% ,4:5%, LEDD= 814±520 mg; Disease duration = 10 years [range: 3-25] ) and a caregiver (%Male =61%, Age = 58±9 years), were monitored for 9.3 ± 3.7 days. Both members wore ankle-mounted Apple Watches in free-living conditions to continuously record step counts. Proximity was tracked using a Bluetooth beacon carried by the caregiver and detected by the patient’s device. Periods were classified as “together” when the patient was within beacon range and “apart” otherwise. Step counts were normalized to steps per hour and compared across proximity conditions using the Mann-Whitney U test. The proportion of time spent together was also calculated for each dyad.

Results: Dyads spent 43.1 ± 26.8% of their monitored time together. Both patients and caregivers moved significantly more per hour when apart than when together. Patients averaged 602 ± 541 steps/hour together versus 817 ± 696 steps/hour apart (p < 0.001), and caregivers averaged 597 ± 551 steps/hour together versus 765 ± 678 steps/hour apart (p < 0.001).

Conclusion: These findings suggest that patients with advanced PD may maintain a degree of functional independence in daily life, as both members of the dyad demonstrated higher mobility during periods of separation. This pattern may reflect engagement in individual daily activities outside shared contexts.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/physical-proximity-influences-mobility-in-advanced-parkinsons-disease-patient-caregiver-dyads/