Man is, by nature, a
social animal. – Aristotle, Politics
Interacting with other people is crucial to our well-being. Social involvement helps shape our own
identity, bolsters perception of our self-worth, and enables our simultaneous
involvement as an individual and as part of a collective.
Just as social interaction benefits many aspects of our
lives, isolation is detrimental to health [1].
A review of studies of hospital patients in isolation showed a negative
impact on mental well-being and behavior, including higher scores for
depression, anxiety, and anger [2]. A
meta-analysis of studies of subjects in social isolation showed that without
regular interaction with others, people experience more mental health issues,
poorer health outcomes, and die younger [3].
Moreover, social activity and engagement correlate with significantly
higher quality of life and life satisfaction scores in people living with a
disease or disability, compared to those without disease/disability [4]. In quantifying predictors of quality of life
in patients with Parkinson disease (PD), investigators found social isolation
was second only to physical mobility as a factor in predicting poorer quality
of life outcomes [5].
Recently diagnosed PD patients often report that they
manipulate social interactions to hide PD symptoms – primarily tremor. Because their motor symptoms are so visible, PD
patients are less inclined to attend social gatherings. They feel, for example, that others are
staring at them or feel uncomfortable in their presence.
What we try to convey to our patients— and what should be
understood by all people with PD— is that we all differ from each other, but
that these differences are usually of no importance. Friends know and accept that someone has a tremor,
just as they perceive another friend is growing bald or has gained weight. People with PD are actually harming
themselves by withdrawing and not enjoying life and normal social interactions. Socialization combats cognitive decline [6] and
gives people a sense of purpose and belonging.
PD is typically a slowly progressive illness and patients
should continue to live their lives as fully as possible. People with PD can, and should, pursue their regular hobbies and recreational activities, particularly
those that include social interactions. Many
patients with PD continue to play golf, participate in runs, travel and learn
about other cultures, attend yoga and tai chi classes, audit college courses, join
dance groups, lead book and gardening clubs, and so on. While PD may add a wrinkle to these
activities, it should not prevent patients from fully engaging in and enjoying them.
Remaining socially engaged has significant positive benefits,
both mentally and physically [7]. While
having PD can interfere with self-esteem, previously enjoyed social and
recreational pursuits remain important, feasible, and beneficial for patients.
References
1. Cacioppo JT, Hawkley LC. Perceived social isolation and
cognition. Trends Cogn Sci (Regul Ed). 2009; 13(10):447-54.
2. Bassuk SS, Glass TA, Berkman LF. Social disengagement and
incident cognitive decline in community-dwelling elderly persons. Ann Intern
Med. 1999; 131(3):165-73.
3. Holt-lunstad J, Smith TB, Layton JB. Social relationships
and mortality risk: a meta-analytic review. PLoS Med. 2010; 7(7):e1000316.
4. Jang Y, Mortimer JA, Haley
WE, Borenstein Graves AR. The Role of Social Engagement in Life Satisfaction:
Its Significance among Older Individuals with Disease and Disability. Journal of Applied Gerontology. 2004; 23:266-278.
5. Forsaa EB, Larsen JP, Wentzel-larsen T, Herlofson K,
Alves G. Predictors and course of health-related quality of life in Parkinson's
disease. Mov Disord. 2008; 23(10):1420-7.
6. Williams KN, Kemper S. Interventions to reduce cognitive
decline in aging. J Psychosoc Nurs Ment Health Serv. 2010;48(5):42-51.
7. Fried LP, Carlson MC, Freedman M, et al. A social model
for health promotion for an aging population: initial evidence on the
Experience Corps model. J Urban Health. 2004;81(1):64-78.
