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.