Background/Aims: Racial differences in the observed prevalence of Parkinson’s disease (PD) may be due to delayed diagnosis among African-Americans. We sought to compare the stage at which African-American and white PD patients present for healthcare, and determine whether perception of disability accounts for racial differences. Methods: Using records of veterans with newly diagnosed PD at the Philadelphia Veterans Affairs Medical Center, we calculated differences in reporting of symptoms as the difference in z-scores on the Unified Parkinson Disease Rating Scale part 2 (disability) and part 3 (motor impairment). Ordinal logistic regression was used to determine predictors of stage at diagnosis. Results: African-American (n = 16) and white (n = 58) veterans with a mean age of 70.1 years were identified. African-Americans presented at a later PD stage than whites (median Hoehn + Yahr stage 2.5 vs. 2.0, p = 0.02) and were more likely to under-report disability relative to motor impairment (81 vs. 40%, p < 0.01). Multivariate analysis showed that under-reporting of disability accounted for much of the effect of race on stage of diagnosis. Conclusions: Under-reporting of disability among African-Americans may account for later stages of PD diagnosis than whites. This study begins to explain the mechanisms underlying observed racial disparities in PD.
© 2011 S. Karger AG, Basel
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Nabila Dahodwala, MD, MS
Parkinson’s Disease and Movement Disorders Center
330 S. 9th St., 2nd floor
Philadelphia, PA 19107 (USA)
Tel. +1 215 829 6708, E-Mail email@example.com
Received: December 13, 2010
Accepted: January 29, 2011
Published online: April 20, 2011
Number of Print Pages : 5
Number of Figures : 1, Number of Tables : 1, Number of References : 21
Vol. 36, No. 3, Year 2011 (Cover Date: June 2011)
Journal Editor: Feigin V.L. (Auckland)
ISSN: 0251-5350 (Print), eISSN: 1423-0208 (Online)
For additional information: http://www.karger.com/NED
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