How vacations affect Parkinson's disease

Vacations are at least as significant for people with Parkinson's as for anyone else. Vacations can be a fun and relaxing experience, but they can also be stressful. For example, a sudden shift towards an unstructured busy and physically demanding daily schedule can make dealing with anti-parkinsonian medication more difficult or lead to fatigue, sleeping problems and worsening of symptoms. Furthermore, individuals with Parkinson’s experience fluctuating symptoms on a daily basis that can significantly interfere with daily activities. Researchers of the Center of Expertise for Parkinson's and Movement Disorders deployed for the first time vacation data of people with Parkinson’s disease and utilized these experiences to investigate the drivers of day-to-day symptom variability.

As a result of the sudden change in almost all contextual daily factors brought about by going on vacation, vacation itself was regarded as a 'natural experiment'. Researchers hypothesized that contextual factors such as daily structure and activities, sleep and temperatures could partly explain the substantial differences in day-to-day symptom variability. 147 people with Parkinson's who had recently returned from vacation filled in a survey that asked for vacation details such as duration, destination, temperature and activity-related factors such as (amount of) exercise, sleep and stress. Participants were then asked how parkinsonian symptoms had changed on vacation.

As many as 44.9% of participants experienced symptom improvement while on vacation, while 12.9% experienced symptom worsening. Improvements were mostly seen in people who had more physical activity, and in this subgroup, walking, pain, cramps and slowness improved most. People who slept better on vacation had improvements in a wide range of motor and non-motor symptoms, while increased stress was associated with broad symptom worsening. Interestingly, vacation duration did not predict the extent of symptom improvement on vacation. Although younger people were slightly more likely to report symptom improvement, disease duration did not predict findings. There were no between-gender differences.

This study gives novel insight in factors that affect day-to-day symptom variability and demonstrates that improvement of specific symptoms is associated with changes in specific contextual factors. It additionally provides clues for personalized symptomatic treatment and provides guidance for the upcoming summer for everyone with Parkinson’s: a recipe for a Parkinson's-friendly vacation.

Interested in the rest of the results too? The study has been published open access in Movement Disorders Clinical Practice.

Janssen Daalen JM, Hubbers J, Sharifi Bonab M, Mathur S, Thijssen DHJ, Bloem BR, Meinders MJ. How Vacations Affect Parkinson's Disease. Mov Disord Clin Pract. 2022 Nov 2;10(1):151-153. doi: 10.1002/mdc3.13597. PMID: 36698995; PMCID: PMC9847288.