A Mixed Methods Exploration of the Impact of the COVID-19 Pandemic on Food-Related Activities and Diet Quality in People with Parkinson Disease

Objective: The purpose of this mixed methods study was to explore the impact of COVID-19 on the ability of people with Parkinson disease (PwPs) and their care-partners to perform food-related activities (FRA) and PwPs' overall diet quality. Methods: Using a convergent parallel mixed methods design, PwPs and their care-partners completed virtual dyadic semi-structured interviews about their FRA during the COVID-19 pandemic. PwPs completed Food Frequency Questionnaires (FFQ) to quantify their dietary intake in the previous 12 months. Qualitative data were analyzed by two coders using thematic analysis, and quantitative data from FFQs were descriptively analyzed to calculate diet quality scores. Results: Eleven dyadic interviews revealed the following key themes: cooking more at home; changes with grocery shopping; less meals with non-household members. These changes were described to increase the care-partners' responsibilities and overall burden. Diet scores among PwPs were 73.0 +/- 6.3 for the Healthy Eating Index 2015 (scale of 0-100), 29.2 +/- 6.6 for the Mediterranean diet (scale of 0-55), and 10.4 +/- 1.8 for the Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet (scale 0-15). Conclusions: Diet scores revealed that PwPs consumed a high-quality diet during the pandemic. Findings from this study highlight the need for tailored nutrition education to support PwPs' care-partners.