Ethnicity and Parkinson’s Disease: Motor and Nonmotor Features and Disease Progression in Latino Patients Living in Rural California

Abstract

Background Parkinson’s Disease (PD) is the second most common neurodegenerative disorder among older adults worldwide. Currently, studies of PD progression rely primarily on White non-Latino patients (WNL). Here, we compare clinical profiles and PD progression in Latino and WNL patients enrolled in a community-based study in rural Central California. Methods PD patients within five years of diagnosis were identified from three counties between 2001-2015. During up to three visits, participants were examined by movement disorders specialists and interviewed. We analyzed cross-sectional differences in PD clinical features severity at each study visit and used linear mixed models and Cox proportional hazards models to compare motor, non-motor, and disability progression longitudinally and to assess time to death in Latino compared to WNL patients. Results Of 775 patients included, 138 (18%) self-identified as Latino and presented with earlier age at diagnosis (63.6 vs. 68.9) and death (78.6 vs. 81.5) than WNL. Motor (HR= 1.17 (95% [0.71, 1.94]) and non-motor symptoms did not progress faster in Latino vs. WNL patients after accounting for differences in baseline symptom severity. However, Latino patients progressed to disability stages according to Hoehn&Yahr faster than WNL (HR= 1.81 [1.11, 2.96]). Motor and non-motor symptoms in Latino patients were also medically managed less well than in WNL. Conclusions Our PD study with a large proportion of Latino enrollees and progression data, reveals disparities in clinical features and progression by ethnicity that may reflect health care access and structural socioeconomic disadvantages in Latino patients with PD.

Racial and Ethnic Disparities in Neurological Care in the United States

“…81 A recent study on Latino patients with PD using data from the Parkinson's Environment and Genes Study (PEG) found that Latinos with PD living in rural Central California had an earlier age of diagnosis, earlier death, and faster progression to disability than White non-Latino individuals. 82 Latino patients in this cohort were also more likely to report long-term employment in farming-related occupations (31% compared with 8%). As a result, investigators postulated that in addition to barriers in access and delays in diagnosis, environmental exposures including pesticide exposures may explain differences in PD onset, disease progression, and outcomes for Latino PD patients in this cohort.…”

“…74 In terms of health outcomes for Latino individuals with PD, the PEG study also found that in addition to faster disease progression, Latinos with PD experienced worse cognitive outcomes compared with White-Non Latino individuals, despite similar PD prescription use, dosages, and PD-related follow-up visits. 82 A separate online study of 25,298 patients with PD found that Latino patients with PD (n ¼ 1,161) reported more depressive symptoms and worse health-related quality of life (HRQOL) compared with White non-Latino patients with PD. 98 This same study found that experiences with discrimination were a significant factor associated with depression and HRQOL in Latino patients with PD.…”

Neurodegeneration: can metabolites from Eremurus persicus help?

“…In recent years, changes in the demographic trend have led to progressive aging of the population worldwide (Klimova and Kuca, 2016). This scenario is associated with a continuous increase in the number of patients affected by neurodegenerative diseases, among which the most widespread are Alzheimer's, Parkinsonism, and amyotrophic lateral sclerosis diseases (Logroscino et al, 2022;Duarte Folle et al, 2023). The treatments available in this field are often disease-specific and involve the use of small molecules, like memantine, carbidopa, or riluzole, or monoclonal antibodies, like aducanumab, but they are always associated with poor efficacy (Lamptey et al, 2022).…”