Objective: To compare the incidence of non-motor symptoms (NMS) across racial and ethnic groups among individuals diagnosed with PD using the TriNetX platform, a global federated network of electronic health record data.

Background: NMS in PD vary widely and greatly impact disease burden. Research gaps on racial and ethnic disparities limit understanding of NMS in diverse populations.

Method: PD Individuals were identified by >= 2 separate occurrences of ICD-10 code G20 in medical records. NMS were grouped into 12 domains, some comprising multiple ICD-10-coded symptoms (Table 1). Hazard ratios [95% CI] compared first NMS occurrence by domain and then by specific individual symptoms between Black non-Latinos (BNL) vs. White non-Latinos (WNL), and Latinos (La) vs. WNL. Race/ethnicity groups were propensity-matched for age, sex, comorbidities, and behavioral and socioeconomic factors before estimating hazard ratios. Follow-up time was limited to 5 years post-first PD diagnosis.

Results: There were 180436 WNL,13070 BNL, and 10953 La with PD diagnoses. Compared to BNL, WNL had lower incidence of weight loss, upper GI symptoms (driven by dysphagia, choking, salivary secretion), bowel symptoms (driven by constipation), and cardiovascular symptoms (driven by edema) (Table 1). Conversely, WNL (vs. BNL) had higher incidence of weight gain, urinary symptoms (urgency and nocturia), cognitive symptoms (mild cognitive impairment [MCI], unspecified cognitive dysfunction), psychiatric/mood symptoms (anxiety, depression), sleep/fatigue (restless legs syndrome, parasomnia, insomnia, unspecified sleep disorder), and diplopia. Compared to the La group, the WNL group had lower incidence of upper GI symptoms (dysphagia, salivary secretion) and bowel symptoms (constipation). However, within the upper GI domain, smell/taste disturbances were more common in WNL. The WNL group (vs. La group) had a higher incidence of urinary symptoms (urgency), cognitive symptoms (MCI, unspecified cognitive dysfunction), sleep/fatigue symptoms (restless legs syndrome, somnolence, parasomnia, unspecified sleep disorder), falls, and diplopia.

Conclusion: Racial/ethnic NMS differences highlight the need for more inclusive PD research to understand symptom presentation and management in underrepresented groups. Next steps include refining our PD case definition and analyzing additional datasets.

Table 1.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/non-motor-symptom-comparisons-by-race-ethnicity-in-thousands-with-pd-diagnosis/