Objective: This study aims to determine the prevalence of PD in rural Nepal and characterize its clinical features in an effort to bridge the gap in data and enhance awareness among healthcare providers and communities.

Background: Parkinson’s disease (PD) is an increasingly recognized neurodegenerative disorder worldwide, yet its burden in rural Nepal remains poorly understood. Limited access to healthcare, under-diagnosis, and cultural perceptions of aging-related tremors contribute to the lack of epidemiological data. Understanding the prevalence and clinical spectrum of PD in these underserved regions is crucial for early diagnosis and improving care.

Method: A community-based cross-sectional study was conducted across multiple rural villages in Nepal. A two-stage screening approach was employed: initial identification of potential cases through a door-to-door survey using a validated PD questionnaire, followed by a neurological examination by movement disorder specialists. Demographic data, motor and non-motor symptoms, disease severity (using the Hoehn & Yahr scale), and medication history were documented.

Results:

Out of 2,500 individuals screened (aged ≥50 years), 67 cases of PD were identified, yielding a prevalence of 2.68%. The mean age at diagnosis was 63.5 ± 8.2 years, with a male predominance (M:F = 1.8:1). Tremor was the most common initial symptom (81%), followed by bradykinesia (74%) and rigidity (59%). Non-motor symptoms, including sleep disturbances (68%) and constipation (54%), were frequently reported but often overlooked. Only 22% of patients had prior medical consultation for their symptoms, and 78% had never received dopaminergic therapy due to limited access and awareness.

Conclusion: PD remains an underdiagnosed and undertreated condition in rural Nepal, with a significant number of patients unaware of their disease. The high prevalence, coupled with delayed healthcare-seeking behavior, underscores the need for improved diagnostic efforts, community education, and better access to movement disorder specialists. Targeted interventions, such as rural screening programs and physician training, are essential to address these gaps in care.

Demographic and Clinical Characteristics

Distribution of Motor and Non-Motor Symptoms

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MDS Abstracts - https://www.mdsabstracts.org/abstract/prevalence-and-clinical-characteristics-of-parkinsons-disease-in-rural-nepal-a-community-based-cross-sectional-study/