Racial and Ethnic Differences in Health-Related Quality of Life for Individuals with Parkinson Disease Across Centers of Excellence.

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Di Luca, Daniel Garbin

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Luo, Sheng

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Liu, Hongliang

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Cohn, Melanie

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Davis, Thomas L

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Ramirez-Zamora, Adoldo

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Rafferty, Miriam

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Dahodwala, Nabila

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Naito, Anna

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Neault, Marilyn

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Beck, James

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Marras, Connie

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2023-05-01T14:03:52Z

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2023-05-01T14:03:52Z

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2023-04

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2023-05-01T14:03:51Z

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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.
dc.identifier

WNL.0000000000207247

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0028-3878

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1526-632X

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https://hdl.handle.net/10161/27260

dc.language

eng

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Ovid Technologies (Wolters Kluwer Health)

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Neurology

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10.1212/wnl.0000000000207247

dc.title

Racial and Ethnic Differences in Health-Related Quality of Life for Individuals with Parkinson Disease Across Centers of Excellence.

dc.type

Journal article

duke.contributor.orcid

Luo, Sheng|0000-0003-4214-5809

pubs.begin-page

10.1212/WNL.0000000000207247

pubs.organisational-group

Duke

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School of Medicine

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Basic Science Departments

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Institutes and Centers

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Biostatistics & Bioinformatics

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Duke Clinical Research Institute

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