Objective: To investigate whether immigrant status in Parkinson’s disease (PD) may be associated with differences in clinical presentation, disease severity, and healthcare engagement.

Background: PD in immigrant populations has been understudied, despite the fact that migratory status and sociocultural barriers can influence diagnosis, clinical course, treatment, and health-related quality of life (QOL).

Method: We conducted a retrospective study using a 25-year longitudinal database on PD (n = 1,213). Initially, we analysed the entire cohort and observed that immigrant patients were younger at diagnosis (62.9 vs. 72.5 years, p < 0.00001) than native-born patients. Therefore, we decided to match the 98 immigrant patients 1:1 with native-born patients by age, sex, and year of diagnosis. Clinical variables included demographics, premotor symptoms, initial symptom, family history, history of dopamine-blocking drugs, Hoehn & Yahr (H&Y) stage, MDS-UPDRS (I-IV), and treatments established for PD, Levodopa Equivalent Daily Dose (LEDD) or psychotropic medications. Indicators of engagement with medical care included missed visits and medication adherence.

Results: The majority of immigrants (68.37%) come from Latin America. In paired analyses, no significant differences were observed in H&Y stage or MDS-UPDRS scores at baseline or follow-up. Hyposmia, as a premotor symptom, was reported less frequently among immigrants (26.5% vs. 49.0%, p = 0.001). There are no significant differences between groups in relation to the presence of family history, initial symptom, time of evolution at the time of diagnosis, PD treatments, LEDD, psychotropic medications, or follow-up time. Immigrants had higher rates of missed visits (34.7% vs. 16.3%, p = 0.003) and lower medication adherence (24.5% vs. 11.2%, p = 0.016) although there were no differences in intolerance to the different drugs.

Conclusion: Immigrant patients with PD do not identify hyposmia as a premotor symptom. Although motor severity and prescribed medications did not differ, immigrant patients experienced poor adherence to follow-up visits and treatment. These findings highlight that the migrant status itself, along with structural and sociocultural factors, likely influences the clinical presentation and management of PD. Further studies are needed to determine whether this results in a worse health-related QOL for immigrant patients with PD.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/immigration-status-and-parkinsons-disease-a-retrospective-matched-cohort-study/