Exploring the Influence of Person and Environmental Factors on Social Participation in People with Parkinson’s Disease

Research Objectives: To investigate person and environmental factors associated with social participation among people with Parkinson’s disease (PD).

Design: Secondary analyses of cross-sectional baseline data from a prospective cohort. Pearson correlation analysis was conducted to identify correlates of social participation. Sequentially, the significant correlates were entered into hierarchical multiple regression models predicting social participation with the following blocks: (1) demographics (e.g., education level); (2) motor symptoms; (3) non-motor symptoms (i.e., depression and cognition); and (4) environmental factors (i.e., social resources).

Setting: University medical center.

Participants: 86 participants with PD (median (interquartile range) age = 67.5 (62.5 to 72.5) years; 37.2% female). Inclusion criteria included diagnosis of idiopathic PD, modified Hoehn and Yahr Stage 1 through 4, and no dementia (score≥26 on Mini-Mental State Exam).

Interventions: Not applicable.

Main Outcome Measures: Social participation was measured by the Social Activities Percent Retained score of the Activity Card Sort, motor symptoms by the Movement Disorder Society Unified PD Rating Scale-III, depression by the Geriatric Depression Scale, cognition by the Montreal Cognitive Assessment, social resources by the total score on the Chronic Illness Resource Survey, and demographics by self-report.

Results: Age and gender did not correlate with social participation and so were not included in the regression models. In hierarchical linear regression models, education accounted for an initial 6.3% of the variance in social participation (p=.02), motor symptoms accounted for an additional 9.5% (p <.01), non-motor symptoms (depression and cognition) added 22.1% (p <.01), and then social resources added 4.0% (p=.02), resulting in a significant model, R2=.419, R2adjusted=.383, p<.01. Motor symptoms (β=-.24), depression (β=-.41), and social resources (β=.23) were each significant independent predictors of social participation.

Conclusions: Along with the impairment factors, better environmental or social support (i.e., quality, composition, and use of social resources) relates to higher social participation among individuals with PD. Healthcare professionals should consider addressing both impairment and environmental factors as part of comprehensive care in PD to promote participation in social activities.

Author(s) Disclosures: No potential conflicts of interest