Table 1.

Summary of results from review papers

Social Role	Sub-theme	Summary of results
General Social Functioning	Clinical Observations/PD Symptoms	Facial masking is correlated with social rejection. Communication problems (e.g. voice problems) can lead to social withdrawal. PD can limit socialization and ability to feel capable of making a meaningful contribution.
	Treatment/ Intervention Effect	A tango class helped increase social support. There is little evidence that traditional therapies (medication and DBS) improve social role functioning. For some people social functioning can decline after DBS surgery, however, psychoeducation can address this decline.
	Quality of Life/ Life Changes after PD	Cognitive functioning is related to social integration. Females report worse social support than males.
Primary Relationships/ Couple	Clinical/PD symptoms	Facial masking and disease severity were associated with worse partner interaction. The added responsibility of taking care of a spouse with PD can strain relationships. Ability to cope with changes predicted psychosocial functioning.
	Relationship Satisfaction (non-sexual aspects)	Non-sexual relationship aspects (e.g. talking, sharing activities) can become more important after PD diagnosis. Female participants still valued being perceived as a wife & mother. Greater relationship mutuality predicted better QoL.
	Sexual Satisfaction	Sexual satisfaction was lower for younger onset People with PD. Sex can become problematic because of decreased drive, fatigue, and rigidity. Sexual satisfaction was associated with marital satisfaction. Predictors of quality of sexual life include male gender, better motor functioning, and quality of sexual life for partner.
	Treatment Effect	Higher levodopa doses were associated with increased thoughts of breaking up. People with PD who participated in a dance class with their spouse found it increased moral support. The effect o DBS on the couple role is mixed.
Parent/ Family Role	Treatment/Intervention	A tango intervention improved family role functioning. After DBS people with PD typically had improved relations with their children.
	Sharing disease/Communication	Family relationships are affected early in the disease. Some people with PD feel the need to “protect” their families from the diagnosis. Some people with PD feel sharing their diagnosis with their families helps them better manage.
	Relationship Satisfaction	Sometimes there is no change in family relationship quality after diagnosis. For some parenting becomes more important after diagnosis.
Friendship Role	Number of social contacts/social connectedness	People with PD are less likely to have many close friends. The number of friends may stay the same, but typically people with PD initiate fewer visits to friends. Some people conceal themselves from others, which disrupts social connectedness.
	Quality of Life	Changes in social contacts also substantially influence quality of life.
	Relationship Quality	Some friendships were strengthened while others lost friends because of the disease. Identification and involvement with the larger PD community was a meaningful source of friendship and support.
Work Role	Clinical/PD Symptoms/Predictors	Age, anxiety, fatigue, motor symptoms, apathy, cognition interfere with work performance.
	Housework	People with PD were less likely to participate in household management.
	Work Unavailability/Leaving the workforce	People with PD are less likely to work. Some people try to keep their jobs as long as they can and worry about losing social connections from work. Reasons for leaving work include being unable to meet demands. People who continue to work try to hide their symptoms and try to maintain job performance rather than working toward a promotion.
	Treatment/Intervention	No evidence that levodopa influences work role. Work activity often became worse after DBS.
Social and Leisure Role	Activity Type	More likely to engage in solitary and/or sedentary activities.
	Treatment/Intervention Effect	No evidence that levodopa helps with social activities. Participation in physical activities (e.g. dance class) helped with social interaction. DBS had no effect on social and leisure role.
	Clinical/PD Symptoms	Hoehn & Yahr stage, fatigue, mobility, and lack of symptom control were related to leisure role functioning. Some people with PD are embarrassed by symptoms which makes them pull away from activities.