Las investigaciones demuestran que las personas con la enfermedad de Parkinson (EP) son hospitalizadas más a menudo, llegan a la sala de urgencias con más frecuencia y son más vulnerables a tener complicaciones durante su hospitalización.

El ejercicio y la actividad física no sólo ayudan a las personas con Parkinson a mantener o mejorar la movilidad, la flexibilidad y el equilibrio a la hora de controlar los síntomas, sino que el movimiento habitual puede ofrecer grandes beneficios en el hospital. Como paciente hospitalizado, el movimiento —a menudo con apoyo de fisioterapia y terapia ocupacional— es esencial para prevenir caídas y minimizar complicaciones.

Un nuevo estudio descubre que mantenerse activo (movilidad en el hospital) beneficia a las personas con Parkinson. Publicado en Parkinsonism & Related Disorders, el estudio apoyado por la Parkinson's Foundation examina cómo el Programa Move to Heal de los Hospitales Universitarios (UH, por sus siglas en inglés) ubicados en Cleveland, Ohio, un programa de movilidad en todo el sistema hospitalario que busca movilizar a todos los pacientes hospitalizados al menos tres veces al día, afecta a los pacientes con la EP.

La movilidad de los pacientes hospitalizados se refiere al movimiento seguro durante la estancia en el hospital (dentro y fuera de la cama) con la aprobación y el apoyo de un equipo de atención médica. Los beneficios incluyen:

• Reducción de la pérdida muscular
• Dormir mejor
• Mejor concentración

La falta de movilidad de los pacientes de edad avanzada durante su hospitalización se asocia a una menor movilidad y a un aumento de la mortalidad tras el alta.

Resultados del estudio 

Para aprender más acerca de los resultados de la movilidad hospitalaria para personas con la EP, el estudio utilizó datos de pacientes ingresados al hospital por más de 24 horas entre febrero y septiembre de 2023, comparando 300 pacientes hospitalizados con Parkinson con 12,000 pacientes sin la EP. Cada grupo se dividió a su vez en un:

• Grupo activo: tres o más movilizaciones al día. Las movilizaciones incluían rango de movimiento activo o pasivo realizado en la cama, sentado en el borde de la cama, sentado en una silla o en una silla retrete, de pie y caminando.
• Grupo inactivo: menos de tres movilizaciones al día.

Los datos mostraron que los pacientes hospitalizados con la EP del grupo activo tuvieron una estancia hospitalaria más corta y una mayor probabilidad de volver a casa tras la hospitalización. Esto apoya las Recomendaciones de atención hospitalaria de la Parkinson's Foundation, que promueve que las personas con la EP se movilicen tres veces al día bajo supervisión profesional. 

En particular, todos los pacientes que permanecieron activos durante su hospitalización tuvieron un 50% menos de probabilidades de morir a los 30 días de recibir el alta hospitalaria y un 30% menos de probabilidades a los 90 días.

Los pacientes hospitalizados que se mantuvieron activos tuvieron un 74% menos de probabilidades de ser dados de alta para cuidados paliativos o de morir, en comparación con los pacientes inactivos.

En general, el estudio sugiere que la movilización frecuente disminuye significativamente la duración de la estancia y aumenta la probabilidad de ser dado de alta para volver a casa para los pacientes con Parkinson, en hospitales con programas de movilización.

Destacados 

• La Parkinson’s Foundation se asoció con los Hospitales Universitarios (UH, por sus siglas en inglés) para comprender mejor cómo afecta a las personas con Parkinson el hecho de permanecer activas en el hospital (lo que se denomina movilización de los pacientes).

• Los datos del estudio compararon a 300 personas hospitalizadas con Parkinson con 12,000 pacientes hospitalizados sin Parkinson.

• Las personas con Parkinson que fueron movilizadas al menos tres veces al día durante su ingreso tuvieron una estancia más corta y fueron dadas de alta para volver a casa (en lugar de a un centro asistencial) con más frecuencia que aquellas que no fueron movilizadas al menos tres veces al día.

• Los pacientes que permanecieron activos durante su hospitalización tuvieron un 50% menos de probabilidades de morir a los 30 días de recibir el alta hospitalaria y un 30% menos de probabilidades a los 90 días.

• Ambos grupos que estuvieron activos (con y sin la EP) tuvieron estancias hospitalarias más cortas que el grupo inactivo, pero el impacto fue más significativo para las personas con la EP. 

• Sólo el grupo de la EP activo mostró una mayor probabilidad de volver a casa tras el alta.

¿Qué significa esto? 

Para las personas con Parkinson, mantener la movilidad en el hospital puede significar una enorme diferencia a la hora de recuperarse y tener más probabilidades de volver a casa en lugar de a otro centro asistencial.

La movilidad en las personas con Parkinson es un aspecto importante del manejo de los síntomas de la EP, tanto en casa como en el hospital. Este estudio demuestra que las personas con la EP tienden a experimentar estancias hospitalarias más largas y a tener mayores tasas de mortalidad si no se mueven con regularidad en el hospital.

Para muchos, puede resultar difícil promover un movimiento regular y programado cuando enfrentan problemas de salud o complicaciones que los llevan al hospital. Este estudio apoya los esfuerzos de la Parkinson's Foundation para promover programas de movilización de los pacientes hospitalizados en todo el sistema, mostrando beneficios significativos para los pacientes y los hospitales, especialmente aquellos con la EP. Con el tiempo, estos programas pueden ayudar a mejorar la calidad de la atención.

¿Qué significan estos hallazgos para las personas con la EP en este momento?

Cada año, más de 300,000 personas con Parkinson reciben atención en un hospital en los EE.UU. Sin embargo, se estima que aproximadamente una de cada seis personas con Parkinson experimenta complicaciones evitables durante una estancia hospitalaria.

No obstante, hay muchas formas de defenderse cuando se prepara para una estancia hospitalaria o la experimenta. La Guía de seguridad hospitalaria contiene herramientas e información útiles para ayudarle durante su próxima visita. Esta guía destaca cinco necesidades de atención hospitalaria, con consejos sobre cómo hablar con el equipo de atención acerca del movimiento dentro del hospital y posteriormente.

Aprenda más 

La Parkinson’s Foundation cree en el empoderamiento de la comunidad de Parkinson a través de la educación. Aprenda más acerca de la EP y la movilidad en nuestros recursos mencionados abajo o llame a nuestra Línea de Ayuda gratuita al 1-800-4PD-INFO (1- 800- 473-4636), opción 3 para español, para obtener respuestas a sus preguntas acerca del Parkinson. 

• Movimiento seguro en el hospital 

• Guía de seguridad hospitalaria

• Guía para recién diagnosticados

• 4 formas en que las personas con Parkinson pueden evitar complicaciones hospitalarias frecuentes

• Para profesionales: Nuestra estrategia de atención: la iniciativa de cuidados hospitalarios

Research shows that people with Parkinson’s disease (PD) are hospitalized more often, visit emergency rooms more frequently, and are more vulnerable to complications while hospitalized.

Exercise and physical activity not only help people with Parkinson’s maintain or improve mobility, flexibility and balance when it comes to managing symptoms, but regular movement can mean big benefits in the hospital. As a hospital patient, movement — often with support from physical and occupational therapy — is essential for preventing falls and minimizing complications.

A new study finds that staying active (inpatient mobility) in the hospital benefits people with Parkinson’s. Published in Parkinsonism & Related Disorders, the Parkinson’s Foundation-supported study looks at how University Hospitals (UH) located in Cleveland, OH, Move to Heal Program, a hospital system-wide mobility program that aims to mobilize all inpatients at least three times daily, affects patients with PD.

Inpatient mobility refers to safe movement during a hospital stay (in and out of bed) with the approval and support of a care team. Benefits include:

• Reduced muscle loss

• Better sleep

• Improved focus

A lack of mobility in older patients while hospitalized is associated with reduced mobility and increased mortality after being discharged.

Study Results 

To learn more about the outcomes of inpatient mobility for people with PD, the study used data from patients admitted at the hospital for more than 24 hours between February to September 2023, comparing 300 hospital patients with Parkinson’s to 12,000 patients without PD. Each group was further divided into an:

• Active group: three mobilizations or more per day. Mobilizations included active or passive range of motion performed in bed, sitting at the edge of the bed, sitting on a chair or bedside commode, standing and walking.

• Inactive group: less than three mobilizations per day.

Data showed that inpatients with PD in the active group had a shorter hospital stay and higher probability of returning home after hospitalization. This supports the Parkinson’s Foundation Hospital Care Recommendations, which advocates that people with PD mobilize three times a day under professional supervision.  

Notably, all patients who stayed active while hospitalized were 50% less likely to die within 30 days of being released from a hospital stay, and 30% lower odds within 90 days.

Hospitalized patients who stayed active were 74% less likely to be discharged to hospice care or die compared to inactive patients.

Overall, the study suggests that frequent mobilization significantly decreases length of stay and likelihood to be discharged home for patients with Parkinson’s, in hospitals with mobilization programs.

Highlights 

• The Parkinson’s Foundation partnered with University Hospitals to better understand how staying active in the hospital (called inpatient mobility) impacts people with Parkinson’s.

• Study data compared 300 hospitalized people with Parkinson’s with 12,000 hospitalized patients without Parkinson’s.

• People with Parkinson’s who were mobilized at least three times a day while admitted had a shorter length of stay and were more often discharged to home (rather than a care facility) than those who were not mobilized at least three times per day.

• Patients who stayed active while hospitalized had 50% lower odds of dying within 30 days of being released from a hospital stay, and 30% lower odds within 90 days.

• Both groups that were active (with and without PD) had shorter hospital stays than the inactive group, but the impact was more significant for those with PD. 

• Only the active PD group showed an increased likelihood of going home after discharge.

What does this mean? 

For people with Parkinson’s, staying mobile in the hospital can make an enormous difference when it comes to recovery and being more likely to go home instead of another care facility.

Mobility in people with Parkinson’s is an important aspect of managing PD symptoms, while at home and in the hospital. This study shows that people with PD are prone to longer hospital stays and increased mortality rates if not moving regularly in the hospital.

For many, it can be difficult to advocate for regular, scheduled movement when you are facing health concerns or complications that lead you to the hospital. This study supports Parkinson’s Foundation efforts to promote system-wide inpatient mobility programs, showing significant benefits to patients and hospitals — especially those with PD. Over time, these programs can help improve quality of care.

What do these findings mean to the people with PD right now? 

Each year more than 300,000 people with Parkinson’s receive care at a hospital in the U.S. Unfortunately, approximately one in six people with Parkinson’s are estimated to experience avoidable complications during a hospital stay.

However, there are many ways to advocate for yourself when preparing for or experiencing a hospital stay. The Hospital Safety Guide contains useful tools and information to help you during your next visit. This guide highlights five hospital care needs, with advice on how to talk with your care team regarding movement in the hospital and beyond.

Learn More 

The Parkinson’s Foundation believes in empowering the Parkinson’s community through education. Learn more about PD and mobility in our below resources, or by calling our free Helpline at 1-800-4PD-INFO (1-800-473-4636) for answers to your Parkinson’s questions. 

• Safe Movement in the Hospital  

• Hospital Safety Guide

• How to Communicate Your 5 Parkinson’s Care Needs During a Hospital Visit

• For Professionals: Our Care Strategy: The Hospital Care Initiative

Some people with Parkinson’s disease (PD) experience changes in thinking or memory — known as cognitive impairment. While some may struggle focusing on a task, others have difficulty remembering information. Cognitive changes can be common when it comes to Parkinson’s and aging, but every person’s experiences and symptoms are unique to them.

Cognitive impairment is related to Parkinson’s because people living with this disease experience a decrease in the level of dopamine in their brain, the neurotransmitter that is involved in regulating the body’s movement and maintaining working memory.

Here are 10 things everyone should know about Parkinson’s and cognitive changes:

1. Cognitive decline is common in Parkinson's.

Mental and movement decline tend to happen together for people with Parkinson’s. Symptoms of mild cognitive impairment often do not interfere with home and work life. The cognitive changes that accompany Parkinson’s early on tend to be limited to one or two mental areas, with severity varying from person to person. Areas most often affected include attention, speed of mental processing, problem-solving and memory issues.

2. Cognitive changes may occur early in the disease.

Doctors used to believe that cognitive changes did not develop until the middle- to late- stages of PD, but recent research suggests that mild changes may be present at the time of diagnosis.

3. Cognitive Change is different than Dementia.

Cognitive impairment is not dementia, which is when cognitive impairments occur in more than one area of cognition. Dementia leads to a more serious loss of intellectual abilities that interferes with daily living. While mild cognitive impairment can affect 20-50% of people with PD, not all lead to a dementia diagnosis.

4. Executive function changes can be frequent in Parkinson’s.

One of the most prominent cognitive changes in Parkinson's is impairment of executive function. This can impact planning, organizing, multitasking and decision-making. Loved ones can help the person with PD by providing cues, reminders and greater structure of activity.

5. Short-term memory problems are associated with cognitive changes.

The basal ganglia and frontal lobes of the brain (both help the brain organize and recall of information) may be damaged in PD. Long-term memory is typically less impacted, however, short-term memory and the ability to recall recent information are often affected. This can result in difficulty with common tasks such as making coffee, checking your emails, etc.

Research has shown that these strategies can help keep your memory sharp:

• Exercise: Finding an activity that you love and can partake in regularly is critical to living with PD. Exercising regularly has been shown to improve cognition and memory problems. The Parkinson’s Foundation’s Fitness Fridays provide a variety of exercises that aim to support those with Parkinson’s.

• Find Mentally Stimulating Hobbies: Reading, puzzles, gardening and art are all examples of hobbies that can keep you entertained while sharpening your mind. It’s important for people with Parkinson’s to find hobbies that can promote mental stimulation.

6. Cognitive Change may alter attention and concentration abilities.

​​​​​​​People with Parkinson’s may have difficulty sustaining attention or concentrating on tasks for extended periods. This can lead to having issues with mental calculations or concentrating during a task.

Here are some tips to help your attention skills:

• Set timers while completing a task to help keep your attention span for the time being. The Pomodoro Technique helps improve focus by working in 25-minute intervals with short breaks in between tasks.

• Nourish your body with foods that promote brain health, such as the “MIND” Diet including food groups like whole grains, berries, and vegetables. Prioritize sleep. A minimum of six hours a night is needed to keep your attention and concentration sharp. Try to stick to a consistent sleep schedule every night, going to bed at the same time, to help your body make it a habit.

7. People in the early stages of PD may have trouble with depth perception.

Subtle visual-perceptual problems may contribute to visual misperceptions or illusions. During early stages of Parkinson’s, people often have trouble measuring distance and depth perception. When PD advances, people with PD face problems with processing information about their surroundings or environment.

8. Up to 50% of people with Parkinson's experience depression.

Up to half of people with PD experience a form of depression during the disease. Depression is more likely to occur in people with Parkinson’s who face severe cognitive impairment. Those suffering with depression can find it harder to control motor symptoms. However, depression is often treatable. Talk to your PD doctor about this symptom.

9. Sleep issues are common in Parkinson’s and can impact cognition.

Problems with falling and staying asleep are very common in people with PD. The effects of sleep problems throughout the night can result in physical and cognitive fatigue throughout the day.
The four main sleeping problems related to PD are:

To address sleep issues, talk to your PD doctor who may prescribe medication or a sleep specialist. Some natural remedies include creating a sleep ritual, avoiding screen time before bed, running a warm bath and more.

• Issues staying asleep and early morning awakening (insomnia).

• Involuntary movements and pain that interrupt sleep.

• Increased nighttime urination.

• Nighttime agitation, vivid dreams and visual misperceptions or hallucinations.

10. There are different treatments to address cognitive changes.

While researchers are still discovering new ways to address cognitive change in people with PD, doctors often recommend a combination of treatments to help with cognitive change.
They can include:

• Cognitive remediation therapy: this treatment emphasizes teaching alternative ways to compensate for memory or thinking problems. It involves using information from neuropsychological testing to identify cognitive strengths that can be used to help overcome weaker areas of thinking.

• Behavioral management: Making changes in the home environment can help minimize memory, visual-perceptual or orientation difficulties.

• Talk to your PD doctor: Your doctor can help you come up with treatments options to address your most bothersome cognitive symptoms. They can also refer a psychiatrist, neuropsychologist, speech or occupational therapist for more assistance.

• Create a support system: Work on building your own support network. Support groups are often amazing resources.

Living well with Parkinson’s takes a team, and some of the most valuable members may not be who you would typically expect. Healthcare professionals, such as physical and occupational therapists, are essential members of your Parkinson’s care team. They help you maintain mobility, independence and communication, working hand-in-hand with movement disorders specialists and neurologists to create a comprehensive, well-rounded care plan that supports your individual needs and overall well-being. 

To showcase these key members of your Parkinson’s care team, we’re highlighting recent podcast episodes that explore the unique benefits of working with a diverse group of medical specialists.

Who should we talk to next? Let us know

Speech-Language Pathologist

Episode 176: The Challenges of Speech and Swallowing Issues

Parkinson’s affects more than just movement, it can also impact the small muscles in the face, mouth, throat and chest. These changes may impact your ability to eat, speak and swallow, and can influence your confidence in conversations.  A speech-language pathologist will assess speech and swallowing challenges and create a treatment plan to help manage these symptoms.

Melissa Grassia Chisholm, MS, CCC-SLP, a licensed speech pathologist and a voice-swallow airway expert, talks about the importance of getting a baseline evaluation with a speech-language pathologist early on in your PD diagnosis and explains how personalized treatment plans can help address speech and swallowing challenges as your needs evolve.

Physical Therapist

Episode 171: Physical Therapy Recommendations for Exercising Safely

As Parkinson’s progresses, overall movement, balance, and coordination may become more challenging. A physical therapist helps you stay active by developing a custom training plan that meets your goals and physical needs.

Patricia S. Brown, PT, DPT, NCS, of Chapman University in California, a physical therapist who specializes in neurological diseases, shares her recommendations on staying motivated and choosing an exercise program that matches your lifestyle goals.

Pharmacist

Episode 167: Exploring Carbidopa-Levodopa for Treating Parkinson’s Symptoms

Managing Parkinson’s symptoms often involves taking multiple medications, making ongoing conversations with your doctor essential. When questions arise, pharmacists can be readily accessible experts who can help address concerns, identify potential drug interactions, and make you feel more confident about your medications.

Emily Peron, PharmD, MS, and Leslie Cloud, MD, MSc, from Virginia Commonwealth University, a Parkinson’s Foundation Center of Excellence, explain the long-term use considerations of carbidopa-levodopa, the different formulations available, and how to recognize when medication adjustments may be needed.

Episode 181: What to Know Before Taking Nutritional Supplements for Parkinson’s

In addition to prescribed Parkinson’s medications, people with PD may explore complementary or alternative therapies, such as herbs or nutritional supplements. Although often available without a prescription, these supplements can pose risks, especially when taken alongside PD medications. That’s why it’s always advisable to speak with your healthcare provider before starting a new medication or over-the-counter supplement.

Angela Hill, Pharm. D., CRPh, a pharmacist and professor at the University of South Florida, a Parkinson’s Foundation Center of Excellence, talks about the potential side effects and drug interactions that can happen with nutritional supplements, and offers tips for reading and evaluating food labels so you can better understand what you’re taking.

Social Worker

Episode 179: Understanding Depression, Anxiety, and Apathy

Social workers are often the go-to resource for connecting you with specialists and services that can help you navigate the day-to-day realities of Parkinson’s. They offer a wealth of guidance and support to ensure that your voice is heard.

Lauren Zelouf, MSW, LCSW from Penn Medicine’s Parkinson’s Disease & Movement Disorders Center, a Parkinson’s Foundation Center of Excellence, tackles the often-overlooked topic of mental health. She breaks down the differences between depression, anxiety and apathy, and offers coping strategies for managing symptoms and finding support.

Managing Parkinson’s involves a team-based approach. Each healthcare professional brings specialized expertise that can help you move better, speak more confidently, and feel better supported throughout your Parkinson’s journey.

Coming Soon: We’re excited to feature another essential member of the Parkinson’s care team—an occupational therapist—in an upcoming episode.

Subscribe to our podcast. Search for “Substantial Matters: Life and Science of Parkinson’s” on your favorite podcast platform.

Listen to every episode at Parkinson.org/Podcast.