Objective: To determine phenotypic differences between African American (AA) and Caucasian patients with Parkinson’s disease (PD) at Rush University Medical Center (RUMC) Movement Disorders Clinic.

Background: In prior studies, AA patients with PD were less likely to receive treatment, more likely to present at a later stage of disease, and have a greater degree of disability overall than Caucasian patients.

Methods: During routine office visits, patient assessments by Movement Disorders neurologists are entered into a clinical research repository. Data was collected on all AA patients with PD seen between 1997-2014. Four aged-matched Caucasian PD patients were randomly selected from the database for each AA patient to serve as controls. Outcomes collected included age, sex, duration of disease, Hoehn and Yahr (HY) stage, thought disorder rating of the UPDRS, medications prescribed, motor and non-motor complications of PD.

Results: 130 AA patients were compared to 528 aged-matched Caucasian control patients. AA patients had longer disease duration (p<0.002), higher HY rating (p<0.0001), and higher thought disorder rating on the UPDRS (p<.01). AA patients were more likely to be taking carbidopa/levodopa at time of presentation compared to Caucasian patients (p<0.007) and less likely to be taking dopamine agonists (p< 0.007), or deprenyl (p<0.006). Using a regression analysis, race was a statistically significant predictor of disease stage (HY stage) after adjusting for age, sex, and carbidopa/levodopa use. Proportional odds model was used in multivariate analysis.

Conclusions: AA PD patients at RUMC Movement Disorders Clinic present at later stages of disease and are less likely to be receiving newer medical therapies when compared to Caucasian counterparts. In future studies, patient interviews will be performed to assess whether there is an identifiable barrier for AA patients to receive care, and whether AA PD patients have a different initial clinical presentation.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/phenotypic-differences-between-african-american-and-caucasian-parkinsons-disease-patients/