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Original Paper

Free Access

Delayed Parkinson’s Disease Diagnosis among African-Americans: The Role of Reporting of Disability

Dahodwala N.a–c · Karlawish J.b, d · Siderowf A.a–c · Duda J.E.a, c · Mandell D.S.b, e

Author affiliations

aParkinson’s Disease Research, Education and Clinical Center, Philadelphia VA Medical Center, and bLeonard Davis Institute of Health Economics and Departments of cNeurology, dMedicine and ePsychiatry, University of Pennsylvania, Philadelphia, Pa., USA

Corresponding Author

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 dahodwan@mail.med.upenn.edu

Related Articles for ""

Neuroepidemiology 2011;36:150–154

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Abstract

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


Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: December 13, 2010
Accepted: January 29, 2011
Published online: April 20, 2011
Issue release date: June 2011

Number of Print Pages: 5
Number of Figures: 1
Number of Tables: 1

ISSN: 0251-5350 (Print)
eISSN: 1423-0208 (Online)

For additional information: http://www.karger.com/NED


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