The following is a summary of “Racial and Ethnic Differences in Health-Related Quality of Life for Individuals With Parkinson Disease Across Centers of Excellence,” published in the May 2023 issue of Neurology by Luca, et al.
There was a lack of representation of racial and ethnic minorities in Parkinson’s disease (PD) research, limiting the understanding of treatment outcomes and health-related quality of life (HRQoL) across diverse populations. For a study, researchers sought to investigate the variability in HRQoL and other outcomes among PD patients of different races and ethnicities.
The retrospective cohort study analyzed data from individuals evaluated at PD Centers of Excellence. A multivariable regression analysis, adjusting for sex, age, disease duration, Hoehn and Yahr (H&Y) stage, comorbidities, and cognitive score, was conducted to examine differences between racial and ethnic groups.
Additionally, a multivariable regression with skewed-t errors was used to assess the contribution of each variable to the association between the 39-item PD Questionnaire (PDQ-39) and race/ethnicity.
The study included 8,514 participants with at least one recorded visit. Among them, 90.2% self-identified as White (n = 7,687), 5.81% as Hispanic (n = 495), 2% as Asian (n = 170), and 1.9% as African American (n = 162). After adjustment, African Americans (PDQ-39 score: 28.56), Hispanics (26.62), and Asians (25.43) had significantly higher (worse) total PDQ-39 scores compared to White patients (22.73, P < 0.001). Similar findings were observed for most PDQ-39 subscales. In the longitudinal analysis, including cognitive scores significantly reduced the strength of association between PDQ-39 scores and race/ethnicity for minority groups. Mediation analysis revealed that cognition partially mediated the association between race/ethnicity and PDQ-39 scores (proportion mediated: 0.251, P < 0.001).
Significant differences in PD outcomes were observed across racial and ethnic groups, even after adjusting for sex, disease duration, H&Y stage, age, and comorbid conditions. Notably, non-White patients had worse HRQoL than White patients, partially explained by cognitive scores. Further research is needed to understand the underlying reasons for these disparities.