Developing Strategies to Decrease Facial Masking in Parkinson's Disease

ABSTRACT Finding ways to keep people socially engaged as they grow older is becoming increasingly important to public health as social engagement is necessary for aging well. Social engagement is particularly imperative for managing disease symptoms for older adults with Parkinson’s disease (PD), a neurodegenerative movement disorder. Facial masking is a motor symptom of PD that results in a decrease in facial expressivity. The reduction in spontaneous facial expression can lead to the experience of stigma and can decrease quality of life and impair relationships with family members and care partners. Facial masking affects expression of all spontaneous emotion, but reduction in expressivity is often most noticeable in the expression of positive emotion. Facial masking leads to a marked decrease in the production of Duchenne smiles, those that create crow’s feet around the eyes. We know that older adults with PD are able to produce deliberate expressions of different emotions with varying degrees of accuracy and intensity, but we do not know how effective these deliberate expressions are at communicating emotion and reducing stigma in people with facial masking. The long-term goal of this research is to evaluate the use of deliberate facial expressions as a viable strategy to alleviate the negative social and emotional consequences of facial masking in people with Parkinson’s disease. The specific aims of the proposed research are to (1) assess how older adults with PD experience producing deliberate expressions and (2) test whether production of deliberate expressions in people with PD differ from production of deliberate expression in healthy age-matched controls to see if they will be perceived similarly. Together the attainment of these objectives will provide evidence for possible self-management strategies to improve interpersonal functioning and quality of life in older adults with decreased spontaneous expression due to PD or other chronic health conditions related to aging.