Xie Tao, Liao Chuanhong, Lee Danielle, Yu Huiyan, Padmanaban Mahesh, Kang Wenjun, Johnson Julie, Alshaikh Jumana, Yuen Carlen, Burns Matthew, Chiu Brian C-H
Department of Neurology, University of Chicago Medicine, IL, 60637, USA.
Department of Public Health Sciences, University of Chicago, IL, 60637, USA.
Parkinsonism Relat Disord. 2021 Jun;87:7-12. doi: 10.1016/j.parkreldis.2021.04.013. Epub 2021 Apr 21.
Racial disparities in diagnosis, treatment and survival in Black patients with Parkinson's disease (PD) compared to White patients have not been well studied, largely due to limited number of studies and information on Black patients in healthcare systems. Studying racial disparities and identifying underlying factors in large populations are important to understand PD and improve care.
We retrospectively identified PD patients on both races from 1/1/2006 to 10/31/2017 and compared demographics, socioeconomic status (educations, incomes and insurances), comorbidities (all categories, including mood, cognition and psychosis), treatment (medications for parkinsonism and major non-motor symptoms, and frequency and locations of healthcare) and survival, and identified factors associated with medication usage and survival.
We retrospectively studied 2033 PD patients, of whom 725 were Black. Black patients lacked male predominance, were 4 years older at first diagnosis here, more likely to smoke and live in a low education and income community, and possessed limited insurances compared to White patients. Black patients also had more comorbidities and were more likely to receive care through emergency or inpatient service, but less likely to be on medications for parkinsonism and mood disorders. Race, age, smoking status, insurance type, frequency and locations of healthcare and comorbidities were associated with medication usage. Black race, older age, inpatient admission and malignancy were associated with increased risk of death.
We revealed racial disparities in diagnosis, treatment and survival, and factors associated with medication usage and survival in the largest reported Black PD cohort from a single center.
与白人帕金森病（PD）患者相比，黑人患者在诊断、治疗和生存方面的种族差异尚未得到充分研究，这主要是由于医疗系统中关于黑人患者的研究和信息数量有限。在大量人群中研究种族差异并确定潜在因素对于理解帕金森病和改善医疗护理很重要。
我们回顾性地确定了2006年1月1日至2017年10月31日期间两个种族的帕金森病患者，并比较了人口统计学特征、社会经济地位（教育程度、收入和保险情况）、合并症（所有类别，包括情绪、认知和精神病）、治疗情况（帕金森病和主要非运动症状的药物治疗以及医疗保健的频率和地点）和生存率，并确定了与药物使用和生存相关的因素。
我们回顾性研究了2033例帕金森病患者，其中725例为黑人。与白人患者相比，黑人患者不存在男性占主导的情况，首次诊断时年龄大4岁，吸烟可能性更大，生活在教育程度和收入较低的社区，且保险有限。黑人患者也有更多的合并症，更有可能通过急诊或住院服务接受治疗，但接受帕金森病和情绪障碍药物治疗的可能性较小。种族、年龄、吸烟状况、保险类型、医疗保健的频率和地点以及合并症与药物使用有关。黑人种族、年龄较大、住院治疗和恶性肿瘤与死亡风险增加有关。
我们在来自单一中心的最大规模已报道黑人帕金森病队列中揭示了诊断、治疗和生存方面的种族差异，以及与药物使用和生存相关的因素。
