Ethnicity and Parkinson's Disease: Motor and Nonmotor Features and Disease Progression in Latino Patients Living in Rural California.

Autor:	Duarte Folle A; Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, California, USA., Flores MES; Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, California, USA.; Altamed, Pico Rivera, California, USA., Kusters C; Department of Human Genetics, David Geffen School of Medicine at UCLA, Los Angeles, California, USA., Paul KC; Department of Neurology, David Geffen School of Medicine at UCLA, Los Angeles, California, USA., Del Rosario I; Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, California, USA., Zhang K; Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, California, USA., Ruiz C; Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, California, USA., Castro E; Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, California, USA., Bronstein J; Department of Neurology, David Geffen School of Medicine at UCLA, Los Angeles, California, USA., Ritz B; Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, California, USA.; Department of Neurology, David Geffen School of Medicine at UCLA, Los Angeles, California, USA., Keener AM; Department of Neurology, David Geffen School of Medicine at UCLA, Los Angeles, California, USA.; Department of Neurology, Veterans Administration Greater Los Angeles Health Care System, Los Angeles, California, USA.
Jazyk:	angličtina
Zdroj:	The journals of gerontology. Series A, Biological sciences and medical sciences [J Gerontol A Biol Sci Med Sci] 2023 Jul 08; Vol. 78 (7), pp. 1258-1268.
DOI:	10.1093/gerona/glad016
Abstrakt:	Background: Parkinson's disease (PD) is the second most common neurodegenerative disorder among older adults worldwide. Currently, studies of PD progression rely primarily on White non-Latino (WNL) patients. Here, we compare clinical profiles and PD progression in Latino and WNL patients enrolled in a community-based study in rural Central California. Method: PD patients within 5 years of diagnosis were identified from 3 counties between 2001 and 2015. During up to 3 visits, participants were examined by movement disorders specialists and interviewed. We analyzed cross-sectional differences in PD clinical features severity at each study visit and used linear mixed models and Cox proportional hazards models to compare motor, nonmotor, and disability progression longitudinally and to assess time to death in Latinos compared to WNL patients. Results: Of 775 patients included, 138 (18%) self-identified as Latino and presented with earlier age at diagnosis (63.6 vs 68.9) and death (78.6 vs 81.5) than WNL. Motor (hazard ratio [HR] = 1.17 [0.71, 1.94]) and nonmotor symptoms did not progress faster in Latino versus WNL patients after accounting for differences in baseline symptom severity. However, Latino patients progressed to disability stages according to Hoehn and Yahr faster than WNL (HR = 1.81 [1.11, 2.96]). Motor and nonmotor symptoms in Latino patients were also medically managed less well than in WNL. Conclusions: Our PD study with a large proportion of Latino enrollees and progression data reveals disparities in clinical features and progression by ethnicity that may reflect healthcare access and structural socioeconomic disadvantages in Latino patients with PD. (© The Author(s) 2023. Published by Oxford University Press on behalf of The Gerontological Society of America.)
Databáze:	MEDLINE
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