The Great Divide

African-Americans and those with lower socioeconomic status have more severe Parkinsonism and suffer greater disability as a result, a recent study suggests.

The most common cause of Parkinsonism is Parkinson's disease (PD), a progressive neurodegenerative disorder with an incidence rate that increases with age. Symptoms of PD include tremor in hands, arms, legs, jaw, and face; rigidity, or stiffness of the limbs and trunk; bradykinesia (slowness of movement) and postural instability (impaired balance and coordination).

Racial minorities and those with low socioeconomic status face worse health outcomes for a lot of diseases, "the effect of race and socioeconomic status on patients with parkinsonism is only beginning to be evaluated," according to the study authors.

J. Patrick Hemming, M.D., and colleagues at the University of Maryland, Baltimore, studied 1,159 patients with parkinsonism who were evaluated by movement disorder specialists between 2003 and 2008. In addition to completing a demographics questionnaire, study participants were assessed for their disease severity and level of disability, and their medication use was obtained from their medical history. African-Americans tended to have more severe parkinsonism and also greater disability than white patients. Lower income and lower educational level were also associated with increased disease severity and disability.

Of those participating, 93.4 percent were white, 6.1 percent were African American, 61.2 percent earned more than $50,000 annually, 62.7 percent completed college and 79.2 percent had a diagnosis of Parkinson's disease.

"There was no disparity in the use of antiparkinsonian medications by income or educational level, although lower socioeconomic status groups were also less likely to receive newer agents," the authors write. "This finding suggests that the racial disparity in Parkinson disease management is not fully explained by income or educational level. Other factors may include physician decision-making, patient acceptance of medications and access to care."