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Neuroepidemiology. 2011;36(3):150-4. doi: 10.1159/000324935. Epub 2011 Apr 20.

Delayed Parkinson's disease diagnosis among African-Americans: the role of reporting of disability.

Author information

  • 1Parkinson's Disease Research, Education and Clinical Center, Philadelphia VA Medical Center, Philadelphia, PA, USA. dahodwan@mail.med.upenn.edu

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.

Copyright © 2011 S. Karger AG, Basel.

PMID:
21508648
[PubMed - indexed for MEDLINE]
PMCID:
PMC3095837
Free PMC Article

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