Frequency of Parkinsonism and Parkinson Disease in African Americans in the Chicago Community

Abstract

Background There is paucity of data about African American (AA) patients with Parkinson’s disease (PD) and parkinsonism which may precede PD in older adults. Prior studies suggest that there are lower rates of PD in the AA population, with more cognitive impairment in AA with PD. This study aimed to investigate differences in PD, parkinsonism, and cognition between White and AA populations in 3 longitudinal epidemiologic cohort studies of aging. Methods This study examined parkinsonism, PD frequency, and cognition of community-dwelling older individuals in 3 longitudinal epidemiologic cohort studies. Parkinsonism was based on an exam utilizing the modified Unified Parkinson’s Disease Rating Scale performed by a nurse. PD was based on self-report, medications used for treatment of PD, and examination findings. Cognition was assessed using 19 performance-based tests that assess 5 cognitive domains. Results AA participants were less likely to have parkinsonism compared to Whites, even with age and gender differences. Frequency of PD was not significant between groups. AA were more likely to have lower cognitive scores as compared to Whites. AA were less likely to have parkinsonism even with controlling for cognitive differences between groups. Conclusions Parkinsonian signs are present among AA in the community at lower rates than in White individuals. Cognitive profiles of AA and Whites with parkinsonism may be different, suggesting differing contributions of pathology to cognitive decline and parkinsonism between groups. Additional research is needed to understand the progression of parkinsonism to PD, as well as to understanding the cognitive differences in AA with parkinsonism.

Under-Diagnosis of Dementia with Lewy Bodies in Individuals Racialized as Black: Hypotheses Regarding Potential Contributors

“…There are multiple proposed contributors to this, including healthcare access/disparities [52][53][54]56], distrust of the medical system [52,53], more comorbidities in Black adults [54], earlier age of mortality in Black adults [53], perceptions of aging (i.e., viewing parkinsonism as part of normal aging) [52,53,57], clinician biases (in diagnosis, treatment) [52,53], and clinician biases related to assessing hypomimia/facial expres-sion [58]. However, there is also community-based research suggesting that parkinsonian signs may be less frequent in older Black adults compared to older White adults [59]. How best to reconcile these findings is uncertain.…”

Role of endocrine PACAP in age-related diseases

“…Parkinson’s disease (PD) is a prevalent age–associated neurodegenerative disease ( 29 ), the pathogenesis of which is modulated by both cell autonomous mechanisms and cell non–autonomous mechanisms of aging ( 30 – 32 ).…”