Abstract
Racial differences in the prevalence of Parkinson’s disease (PD) have been reported for decades. Many of the earliest reports were flawed because they were based on crude datasets, such as hospital databases, death certificates, door-to-door surveys and records of Medicare beneficiaries. These studies provided conflicting results and were found to have numerous biases. Publications with improved study designs in recent years have yielded higher quality findings that are worth reviewing. We reviewed studies published between 2005 and 2014 that analyzed the racial differences in Parkinson’s disease diagnosis, treatment—including deep brain stimulation—and access to care. Literature searches were conducted in PubMed and EBSCO. These studies highlight advances in the field and explore differences in PD among ethnic and racial groups. Our literature review focused on prevalence, treatment and diagnosis discrepancies, and racial variations in the perceptions of aging. An appraisal of twelve reviewed studies determined a decrease in prevalence and incidence of PD in Americans of African descent compared to Caucasians. The studies also showed multiple health disparities, including lack of access to care, treatment, and inclusion in research. More studies are needed to address the causes and prevention of health disparities, as well as solutions, such as community outreach.
Highlights
Parkinson’s disease (PD) is a neurodegenerative disorder that is diagnosed based on clinical features, including bradykinesia, resting tremor, rigidity, and postural stability
The authors evaluated the prevalence of PD among patients who self-identified as African-Americans compared to whites (93.4% white and 6.1% African-American)
The study revealed that African-Americans, at the time of diagnosis, had greater disability, disease severity, and were prescribed fewer anti-parkinson medications than Caucasians
Summary
Parkinson’s disease (PD) is a neurodegenerative disorder that is diagnosed based on clinical features, including bradykinesia, resting tremor, rigidity, and postural stability. These clinical findings are essential for physicians to make an accurate diagnosis, which subsequently will lead to improvement of clinical outcomes and quality of care. Branson et al 88 have suggested there is a lower prevalence of PD among African-Americans. It is unclear if this is due to genetics, or inequalities among access to care, diagnosis, and treatment
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