Parkinson's Disease in Populations of African Origin A Review

Richards, M. A.; Kr, Chaudhuri

doi:10.1159/000109910

Cited by 27 publications

(17 citation statements)

References 29 publications

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“…This strong association persisted in the multivariate analysis and was not confounded by inclusion of other risk factors into the final model. Populations of African origin have been shown to have a greater prevalence of cardiovascular disease than white populations, in particular the risk factor hypertension [37,38]. Interestingly, studies in these populations report among the lowest prevalence ratios of PD, which supports the belief that there is a protective effect of hypertension for disease development.…”

Section: Discussionmentioning

confidence: 94%

The Epidemiology of Parkinson’s Disease in an Australian Population

et al. 1998

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A prevalence study of Parkinson’s disease (PD) was conducted in the rural town of Nambour, Australia. There were 5 cases of PD in a study population of 1207, yielding a crude prevalence ratio of 414 per 100,000 (95% confidence interval; 53–775). We performed a separate case-control study involving 224 patients with PD and 310 controls from South East Queensland and Central West New South Wales, to determine which factors increase the risk for PD in Australia. A positive family history of PD was the strongest risk factor for the development of the disease (odds ratio = 3.4; p < 0.001). In addition, rural residency was a significant risk factor for PD (odds ratio = 1.8, p < 0.001). Hypertension, stroke and well water ingestion were inversely correlated with the development of PD. There was no significant difference between patients and controls for exposure to herbicides and pesticides, head injury, smoking or depression. The high prevalence of PD in Nambour may be explained by rural residency. However, the most significant risk factor for PD was a positive family hisotry. This demonstrates the need for improved understanding of the genetic nature of the disease.

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Section: Discussionmentioning

confidence: 94%

The Epidemiology of Parkinson’s Disease in an Australian Population

et al. 1998

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“…Studies to assess the prevalence of PD in African American populations show varied results. 11,12 A review of 20 studies 13 concluded that differences in prevalence in African Americans com-pared with European populations remain unproven. Some evidence suggests that PD is underdiagnosed in African Americans.…”

Section: Discussionmentioning

confidence: 99%

Racial and Socioeconomic Disparities in Parkinsonism

Hemming

Gruber‐Baldini²,

Anderson³

et al. 2011

Arch Neurol

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To assess potential racial and socioeconomic disparities in patients with parkinsonism treated at a tertiary Movement Disorders Center.Methods: Patients with parkinsonism were evaluated for demographics (age, race, annual income, and educational level), medical comorbidities, medication regimen, disability (Older Americans Resources and Services subcale), presence of Parkinson disease, and disease severity (Unified Parkinson Disease Rating Scale). Disability and disease severity measures were compared by race, income, and educational level using analysis of variance for continuous variables and 2 tests for dichotomous variables.Results: The sample included 1159 patients with parkinsonism (93.4% white, 6.1% African American, 61.2% who earned more than $50 000 annually, 62.7% who completed college, and 79.2% with a diagnosis of Parkinson disease). Cross-sectional analyses by race, income, and educational level showed greater disability and disease severity in African American compared with white patients (African American vs white Older Americans Re-sources and Services subscale total score, 29.8 vs 25.3, P =.005; Unified Parkinson's Disease Rating Scale total score, 53.0 vs 42.8; PϽ .001). African Americans were less likely to be prescribed dopaminergic medications, particularly newer agents (African Americans 20.6% vs whites: 41.1%; P=.01). Lower income and lower educational level were independently associated with greater disease severity and disability (PϽ .003). Conclusion:Racial and socioeconomic disparities exist among patients with parkinsonism being treated at a tertiary Movement Disorders Center. African Americans and those with lower socioeconomic status have greater disease severity and disability than whites. These disparities may be because of problems in diagnosis, access to care, physician referrals, and patient attitudes regarding the appropriate threshold for seeking treatment at a specialized center. Understanding and correction of these disparities may improve outcomes.

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“…PD in people of African-Caribbean origin living in the UK has been implicated to present with atypical features, such as lateonset disease, L-dopa hyporesponsiveness, and early cognitive dysfunction [3,25]. An imaging study has shown that the atypical Parkinsonian phenotype seen in AfricanCaribbean and Indian patients in several London hospitals represents an L-dopa-refractory form of PD separate from multiple system atrophy (MSA) or progressive supranuclear palsy (PSP), given that no neuroimaging signs of these entities were observed and that cerebral vascular lesion load was also not significantly increased in these patients [11].…”

Section: Discussionmentioning

confidence: 99%

Parkinsonism in a population of northern Tanzania: a community-based door-to-door study in combination with a prospective hospital-based evaluation

et al. 2009

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The prevalence of Parkinson's disease (PD) in sub-Saharan Africa is still a matter of debate. The few studies that have been conducted have shown prevalences lower than those in the western world. Whether this represents a genuine finding is unclear to date. In northern Tanzania, we have conducted a hospital-based evaluation and a community-based door-to-door study to assess the prevalence of Parkinsonism, including that of PD. Over a period of 8 months, all patients admitted to a mid-size rural hospital were screened for PD. In parallel, 1,569 people aged >or=50 years were recruited from the communities and assessed for PD with standard questions. Sampling was performed according to the method of "multistage cluster sampling." The questions had previously been tested in a pilot study prior to the survey. People who screened positive were examined by a specialist neurologist. In the hospital, eight of 740 people with neurological diagnoses had Parkinsonism, of whom three patients had a diagnosis of PD. In the community-based study, 18 people answered positively to least one of the 12 screening questions. However, the diagnosis of PD could not be confirmed by further examination in any of them. The prevalence of PD in northern Tanzania was found to be very low. This result would need confirmation in studies with larger populations, ideally of different African ethnicities.

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Parkinson's Disease in Populations of African Origin A Review

Cited by 27 publications

References 29 publications

The Epidemiology of Parkinson’s Disease in an Australian Population

The Epidemiology of Parkinson’s Disease in an Australian Population

Racial and Socioeconomic Disparities in Parkinsonism

Parkinsonism in a population of northern Tanzania: a community-based door-to-door study in combination with a prospective hospital-based evaluation

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