Background: Associations between certain environmental and lifestyle factors and Parkinson's disease (PD) have been reported in several studies, but information on these factors and Parkinson's Disease (PD) in South Asia, is limited. Objective:To determine associations between lifestyle factors and PD in an urban clinic-based study in Sri Lanka. Methods:In this case-control study, demographic and lifestyle factor data (including diet, coffee/tea drinking, smoking, alcohol status) was collected from an unselected cohort of PD patients and age and gender-matched controls attending clinics in Greater Colombo, Sri Lanka. Associations between lifestyle factors and PD status were assessed using Logistic Regression analysis, while links with age of PD onset were explored with Kaplan Meier and Cox Regression survival analyses. Results with p<0.05 were considered to be statistically significant. Findings:Of 229 patients with parkinsonism, 144 had Idiopathic PD using standard diagnostic criteria. Controls numbered 102. Coffee drinkers and smokers were significantly less likely to have PD (coffee, p<0.001; Odds Ratio (OR)=0.264; smoking, p=0.043; OR=0.394). Coffee drinkers were older at PD onset (p<0.001). Similar trends seen with tea drinking were not statistically significant.

Background: Progressive neurological genetic diseases are not rare. They cause psychosocial damages to its victims. This article focuses on common psychosocial issues faced by those from the developing world. Methods: A multicentre observational survey of 246 patients from teaching hospitals in Sri Lanka. Participants were clinically and genetically confirmed by neurologists and the Interdisciplinary Centre for Innovation in Biotechnology and Neuroscience (ICIBN) respectively from 2014 to 2018. Convenience sample with random geographical distribution. Factors were equally weighted. ANOVA, Student’s t-test and chi-square analysis were used. Statistical Software R Statistics—version 3.5 and one-sample t-test with CI = 95% was used. This study meets the ethical guidelines of the local institutional review boards which are in compliance with the Helsinki Declaration. Results: Sample included 184 males and 62 females of 3–76 years with either Duchenne muscular dystrophy (n=121), spinocerebellar ataxia ( n = 87) or Huntington disease ( n = 38). Mean income of the affected is lower than the standard average monthly income ( P ≤ .001). Consultation visits depend on the monthly income (CI 20421.074–34709.361; P ≤ .001). Conclusion: Poverty is inversely proportionate to the patients’ living conditions. As developing countries are financially challenged, it is a societal challenge to rebuild our values to enhance their living status.

Background: Sri Lanka is a rapidly aging country, where dementia prevalence will increase significantly in the future. Thus, inexpensive and sensitive cognitive screening tools are crucial. Objectives: To assess the reliability, validity, and diagnostic accuracy of the Sinhalese version of the Addenbrooke’s Cognitive Examination-Revised (ACE-R s). Method: The ACE-R was translated into Sinhala with cultural and linguistic adaptations and administered, together with the Sinhala version of the Montreal Cognitive Assessment (MoCA), to 99 patients with dementia and 93 gender-matched controls. Results: The ACE-R s cutoff score for dementia was 80 (sensitivity 91.9%, specificity 76.3%). The areas under the curve for the ACE-R s, Mini-Mental State Examination (MMSE) and MoCA were 0.90, 0.86, and 0.86, respectively. The ­ACE-R s had good interrater reliability (intraclass correlation = 0.94), test-retest reliability (intraclass correlation = 0.99), and internal consistency (Cronbach’s α = 0.8442). Conclusions: The ACE-R s is sensitive, specific and reliable to detect dementia in persons aged ≥50 years in a Sinhala-speaking population and its diagnostic accuracy is superior to previously validated tools (MMSE and MoCA).

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