Browsing by Author "Dahodwala, Nabila"

Filter results by typing the first few letters
Now showing 1 - 2 of 2
  • Thumbnail Image
    ItemOpen Access
    Ethnoracial differences for caregiving burden in Parkinson's disease.
    (Parkinsonism & related disorders, 2023-11) Bayram, Ece; Liu, Hongliang; Luo, Sheng; Di Luca, Daniel G; Skipworth, Michael; Damron Solomon, Lisa; Dahodwala, Nabila; Litvan, Irene

    Introduction

    Caregivers play an important role in Parkinson's disease (PD) treatment, especially as the disease progresses. As the symptom profile and needs of people with PD (PwP) differ across ethnoracial groups, whether caregiving needs also differ for different ethnoracial groups should be investigated.

    Methods

    Data were obtained from the Parkinson's Foundation funded Parkinson's Outcomes Project for PwP identifying as Hispanic (n = 495), non-Hispanic Asian (n = 170), non-Hispanic Black (n = 162), or non-Hispanic White (n = 7687). Cross-sectional and longitudinal total Multidimensional Caregiver Strain Index (MCSI) and domain-specific scores for caregiving burden were compared across the ethnoracial groups. Effect of demographics and clinical variables, interaction of these variables with ethnoracial groups for caregiver burden was assessed.

    Results

    Care partners of PwP identifying as non-Hispanic Asian experienced the most burden. PwP identifying as non-Hispanic White were oldest, yet their care partners experienced the least burden. Care partners of PwP identifying as non-Hispanic Asian experienced more burden in physical and social domains, care partners of PwP identifying as Hispanic experienced more burden in financial and elder demanding/manipulative domains. Over time, burden increased similarly across the ethnoracial groups. Effect of frequency of falls, hospital admission, neuropsychiatric disorder and social support on burden over time differed across the groups.

    Conclusion

    PwP from different ethnoracial groups can experience different levels of caregiving burden. Predictors for caregiving burden, such as social support and falls can have different impacts based on ethnicity and race. Caregiver needs should also be assessed and culturally competent support should be provided to benefit all affected by PD.
  • Thumbnail Image
    ItemOpen Access
    Racial and Ethnic Differences in Health-Related Quality of Life for Individuals with Parkinson Disease Across Centers of Excellence.
    (Neurology, 2023-04) Di Luca, Daniel Garbin; Luo, Sheng; Liu, Hongliang; Cohn, Melanie; Davis, Thomas L; Ramirez-Zamora, Adoldo; Rafferty, Miriam; Dahodwala, Nabila; Naito, Anna; Neault, Marilyn; Beck, James; Marras, Connie

    Background and objectives

    Racial and ethnic minorities have been underrepresented in Parkinson's disease (PD) research, limiting our understanding of treatments and outcomes across all non-White groups. The goal of this research is to investigate variability in health-related quality of life (HRQoL), and other outcomes in patients with PD across different races and ethnicities.

    Methods

    This was a retrospective, cross-sectional and longitudinal, cohort study of individuals evaluated at PD Centers of Excellence. A multivariable regression analysis adjusted for sex, age, disease duration, Hoehn and Yahr (H&Y) Stage, comorbidities and cognitive score was used to investigate differences between racial and ethnic groups. A multivariable regression with skewed-t errors was performed to assess the individual contribution of each variable to the association of PDQ-39 with race and ethnicity.

    Results

    A total of 8,514 participants had at least one recorded visit. The majority (90.2%) self-identified as White (n=7,687), followed by 5.81% Hispanic (n=495), 2% Asians (n=170), and 1.9% African American (162). After adjustment, total PDQ-39 scores were significantly higher (worse) in African Americans (28.56), Hispanics (26.62) and Asians (25.43) when compared to White patients (22.73, p<0.001). This difference was also significant in most PDQ-39 subscales. In the longitudinal analysis, the inclusion of cognitive scores significantly decreased the strength of association of PDQ-39, race/ethnicity for minority groups. A mediation analysis demonstrated that cognition partially mediated the association between race/ethnicity and PDQ-39 scores (proportion mediated 0.251, p <0.001).

    Discussion

    There were differences in PD outcomes across racial and ethnic groups, even after adjustment for sex, disease duration, HY stage, age and some comorbid conditions. Most notably, there was worse HRQoL among non-Whites when compared to White patients, which was partially explained by cognitive scores. The underlying reason for these differences needs to be a focus of future research.