These results were presented in the study “Parkinson’s Stress and Mindfulness – A Survey of 5000 Patients, ”Published in NPJ Parkinson’s Disease.
A team led by researchers in the Netherlands sent a survey about the Michael J. Fox Foundation’s Fox Insight program. The survey asked a variety of questions about stress, Parkinson’s and related factors.
Survey responses were returned from 5,000 patients and 1,292 control subjects, mainly relatives, spouses, or friends of patients without Parkinson’s disease. The mean age of the patients was 67.3 years, their mean illness duration was 5.9 years and 48.6% were women. The mean age among controls was 60.8 years and 78.0% were women.
Most of the respondents (93%) were white and most (82.6%) lived in the United States. Notably, not all respondents answered every question. The researchers analyzed the available data.
Analyzes showed that the perceived stress in Parkinson’s patients was generally higher than in control persons. This effect is also “much greater for men than for women,” the researchers wrote.
Parkinson’s patients also scored higher than controls on measures of anxiety and depression and lower scores on dispositional mindfulness (a trait that enables a person to become aware of the present moment while doing normal tasks). These differences were all independent of age or gender.
In the patients, higher levels of stress were associated with worse symptoms for all of the symptoms studied (including sleep disorders, depression, involuntary movement, and slowness of movement).
The symptom most affected by stress was tremor: 81.8% of patients reported that the tremor worsened during periods of stress.
“It should be noted, however, that PD [Parkinson’s disease] Patients can perceive externally observable symptoms such as tremors more easily than slow movement or muscle stiffness, which could (in part) explain the difference between tremors and other motor symptoms, ”the researchers wrote.
It was also found that patients who reported higher levels of stress were more likely to report lower scores for quality of life, self-compassion, and dispositional mindfulness. Stressed patients were also more likely to have high values associated with rumination (they kept thinking about the same thoughts, often sad or dark).
In free-text parts of the survey, patients often said that stress made their cognitive and communication difficulties worse and that emotional symptoms, such as anxiety, increased.
Exercise was the most frequently reported stress reduction strategy in the survey, which was cited by 83.1% of patients. Other common approaches to relieving stress have included religion, music, the arts, reading, taking anxiety medication or antidepressants, and seeking social support (such as talking to a friend).
Over a third (38.7%) of Parkinson’s patients said they practice mindfulness – which means focusing on the present moment rather than focusing on the past or worrying about the future.
Remarkably, patients who were mindfulness users reported significantly higher dispositional mindfulness and also a higher perception of stress and anxiety. The researchers found that it is difficult to work out cause-and-effect relationships from this data. For example, people who are more stressed may be more likely to seek mindfulness, or mindfulness practitioners may be more likely to be more in touch with, and therefore more likely to recognize, feelings of stress or anxiety.
Mindfulness was also associated with less severe symptoms for all measured motor and non-motor symptoms.
“Patients perceived a positive effect of mindfulness on their symptoms,” the researchers wrote.
“The highest effects were seen with depression and anxiety, with 60.2% and 64.7% seeing improvement, respectively,” they added.
About half of mindfulness users (53.2%) practiced this technique once a week or more, while over a fifth (21.5%) practiced mindfulness once a month or less. In general, those who practiced mindfulness more frequently reported greater relief from their symptoms, but consistent benefits were seen in all mindfulness users regardless of frequency.
The researchers speculated that even if people did not actively practice mindfulness, they might incorporate it more informally into their lives through subtle changes in lifestyle or thought patterns.
These findings “[support] the idea that mindfulness is effective at reducing Parkinson’s disease symptoms, ”the researchers wrote, although they again found they could not determine cause and effect from this data. Rather, “people for whom mindfulness is most effective might consequently practice it more.”
The researchers called for more studies, particularly in larger and more diverse groups, to better understand the effects of stress on people with Parkinson’s disease, as well as the potential benefits of practicing mindfulness.
“The significant positive effects patients have experienced from self-management strategies such as mindfulness and exercise will fuel future studies of the clinical effects and underlying mechanisms of these therapies,” they concluded.
Marisa holds an MS in Cellular and Molecular Pathology from the University of Pittsburgh, where she studied Novel Genetic Drivers of Ovarian Cancer. She specializes in cancer biology, immunology and genetics. Marisa started working with BioNews in 2018, and has written about science and health for SelfHacked and the Genetics Society of America. She also writes / composes musicals and coaches the University of Pittsburgh fencing club.
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Ana received her PhD in Immunology from the University of Lisbon and worked as a postdoctoral fellow at the Instituto de Medicina Molecular (iMM) in Lisbon, Portugal. She holds a BSc in Genetics from the University of Newcastle and a Masters in Biomolecular Archeology from the University of Manchester, England. After leaving the lab to pursue a career in science communication, she was director of science communication at iMM.