Objective: We aim to compare self-described Hispanic versus non-Hispanic patients in UT Health movement disorders clinic with Parkinson’s disease (PD).

Background: San Antonio has a majority Hispanic population, with studies showing higher incidence rates of PD in Hispanics compared to other ethnic groups. However, they face significant barriers to diagnosis and treatment, including gaps in accessing healthcare and lack of culturally centered care.

Method: We present the results of initial retrospective analysis of patients with diagnosis of PD at initial evaluation in the movement disorders clinic between July 2014 and December 2022. Differences between Hispanic and non-Hispanic PD patients were compared using independent t-test and Pearson’s chi-square test.

Results: Total of 593 patients with PD were included in this analysis. Among these, a third of them identified as Hispanic. Majority of patients were Men (61.4%) and White (96.8%). Most of them (95.5%) had some form of primary insurance: nearly half were covered under Medicare original, with a difference between subgroups (33.3% vs 50.8%, P<0.001). Majority of patients endorsed presence of resting tremor without difference between the subgroups, however Hispanics had lower rates of reported action tremor (39.0% vs 50.3%, p=0.01). They also had higher mean UPDRS motor score (38.6 vs 34, P=0.002). Distribution of non-motor symptoms was similar between the subgroups, but Hispanics reported cognitive issues less frequently (34.9 vs 49.5%, P=0.001). There was no difference in mean number of years from onset of PD symptoms until diagnosis. More than half of the PD patients were on some formulation of levodopa, followed by dopamine agonist. There was no significant difference in levodopa equivalent doses (LEDD) between the subgroups. Hispanic patients had significantly higher frequency of co-morbid hypertension and diabetes.

Conclusion: In this subgroup analysis, Hispanic patients with PD had worse motor scores despite similar LEDD and disease severity (H&Y) compared to non-Hispanics. Whether this reflects differences in PD phenotype or under dosing due to health disparities remains unclear. They also reported fewer cognitive complaints despite greater vascular risk factors. It is uncertain if this stems from cultural differences in reports, under diagnosis due to disparities, or a distinct PD phenotype, warranting further investigation.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/health-care-inequalities-in-detection-diagnosis-and-treatment-of-parkinsons-disease-among-hispanic-population-in-texas/