Objective: To investigate treatment, health-related quality of life, and other outcome differences in patients with Parkinson’s Disease (PD) across race and ethnicity.
Background: The inclusion of traditionally underrepresented minorities in PD research has been historically low, limiting our understanding of PD care patterns and outcomes across different racial and ethnic groups.
Method: This is a cross-sectional analysis of adult PD patients participating in the Parkinson Foundation Parkinson’s Outcomes Project (PF-POP). The primary outcome was PD quality of life based on PDQ-39 scores. Secondary variables of interest included differences in therapies, modified caregiver strain index (MCSI), falls and hospitalization. T-tests were used to report differences in means, and Chi-square tests for categorical variables. A multivariable regression analysis adjusted for sex, age, disease duration, Hoehn and Yahr Stage and cognitive score was used to investigate differences in clinical outcomes.
Results: 12729 participants had at least one visit since entering the study. The majority (94.6%) self-identified as White (12043), followed by 2.3% Asians (292), 1.5% Black (197), 0.6% American Indian (84), and 0.2% Pacific Islander (25). In regard to ethnicity, 93.1% of patients self-identified as Non-Hispanic/Latino (11522), and 6.9% Hispanic/Latino (862). After adjusting for disease duration, the mean levodopa equivalent daily dose was significantly higher in White patients (mean 263, SD 415) when compared to Black (mean 146, SD 330) and other minorities (p=0.054). Hispanic patients were less likely to be referred to other ancillary services, including physical therapy (p<0.001), speech therapy (p<0.001) and mental health services (p=0.002). After adjustment, total PDQ-39 scores were significantly worse in minority groups when compared to White patients (p=0.003) and non-Hispanic/Latino (p=0.014). Number of emergency department and hospital admissions did not differ among racial and ethnic groups.
Conclusion: There were several racial and ethnic differences in PD management and clinical outcomes, most notably, lower levodopa equivalent dose intake (LEDD) and worse quality of life among non-Whites when compared to White patients. It is important to understand reasons for difference in care patterns to improve outcomes for minorities with PD.
To cite this abstract in AMA style:D. Di Luca, S. Luo, T. Davis, A. Ramirez-Zamora, M. Rafferty, N. Dahodwala, C. Marras. Racial and ethnic differences in patients with Parkinson’s Disease across Parkinson’s Disease Centers of Excellence [abstract]. Mov Disord. 2021; 36 (suppl 1). https://www.mdsabstracts.org/abstract/racial-and-ethnic-differences-in-patients-with-parkinsons-disease-across-parkinsons-disease-centers-of-excellence/. Accessed December 7, 2023.
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MDS Abstracts - https://www.mdsabstracts.org/abstract/racial-and-ethnic-differences-in-patients-with-parkinsons-disease-across-parkinsons-disease-centers-of-excellence/