Objective: This study evaluated the impact of environmental factors on the progression of Parkinson’s Disease (PD) in Texas using a claims-based algorithm to identify severity levels

across time.

Background: Many researchers suggest that PD may have an association to environmental factors such as exposure to toxins, certain chemicals, pesticides, metals, poor water quality, and industrial solvents. Texas not only represents 10% of the nation’s population but also has wide geographic exposure to environmental toxins found in metropolitan and rural areas. Severity level assignment is possible using a refined algorithm designed by this research team that can classify a person with Parkinson’s Disease (PwP) at early, mid or late stage at a point in time. This severity assignment allows researchers to evaluate time progression of severity and disease outcomes at a population level.

Method: The Texas All-Payor-Claims-Database (TX-APCD) contains claims for 82,686 PwP (~9% of the nation’s estimated prevalence). Applying an algorithm that abstracts demographics, diagnoses, symptoms, procedures, and levodopa equivalent dosage (LED) we assigned a monthly severity level (Early, Mid, Late) to PwP in claims data. We then assigned an environmental risk factor to distinct geographic areas within the state that linked to PwP residence zip codes. The TX-APCD data holds claims from 2019 to present, allowing for analyses across 6 years, 72 months. Statistical analyses assessed the impact of geographical exposure to air pollution (PM2.5), pesticides (Paraquat), and chemical trichloroethylene (TCE) on disease progressing, while controlling for confounders such as age.

Results: The prevalence rate of PD in Texas ranges from 134 per 100,000 in the midwest to 346 per 100,000 in the northeast. Pesticide levels are highest in the panhandle. Chemical releases are greatest in the area near the Houston ship channel and air pollution is highest near the border of Mexico. Researchers are in the midst of analyzing the progression of disease and its significance to disease progression. Actual results will be available by the date of presentation.

Conclusion: The hypothesis is that environmental factors found in geographic regions of Texas have a significant impact on the progression of Parkinson’s Disease

in Texas. It is also believed that the research will identify a difference in the type of toxic exposure.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/assessment-of-the-impact-of-environmental-factors-on-disease-progression-in-parkinsons-disease/