Comparison of motor, non-motor, and quality of life phenotype in Black and White patients with Parkinson's disease


      • Very few studies have been conducted focused on Parkinson's disease in the Black population.
      • Quantitative measures, not motor rating scales, detected phenotypic differences in Black PD.
      • Impact of the disease on physical function was rated worse by Black PD patients.
      • Black PD patients reported worse quality of life and had less support or resources for information.
      • Black PD patients also had worse ability to participate in social roles/activities.



      To determine phenotypic differences between Black and White patients with Parkinson's disease (PD).
      Design/Methods: Patients with PD in a movement disorders clinic were approached to participate. After consent, a battery of tests was completed, including MDS-UPDRS Part III and the motor domains of the NIH Toolbox, Montreal Cognitive Assessment, Single Digit Modality Test, Patient-Reported Outcomes Measurement Information System (PROMIS) measures, Parkinson's Disease Questionnaire (PDQ39), Schwab and England, Epworth Sleepiness Scale, UPSIT smell test, and others.


      Twenty-four Black PD and 25 White PD patients participated. There were no differences in demographics and MDS-UPDRS Part III scores. White PD participants performed better on the 4-m walk gait speed test (p < 0.0005), standing balance test (p < 0.001), Montreal Cognitive Assessment (p < 0.0005), and Single Digit Modality Test (p < 0.005). Black PD participants had lower scores on PROMIS Satisfaction with Participation (p = 0.023), PROMIS Physical Function Mobility (p = 0.007), total PDQ39 (p = 0.008), PDQ39 mobility (p = 0.012), PDQ39 ADL (p = 0.014), PDQ39 cognition (p = 0.023), and PDQ39 body discomfort (p = 0.041) scales.


      Significant differences were found in motor, non-motor and quality of life scales in Black and White PD participants with similar demographics. Further work will need to be done to identify the underlying reasons and ways to mitigate these disparities.


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        • Van Den Eeden S.K.
        • Tanner C.M.
        • Bernstein A.L.
        • Fross R.D.
        • Leimpeter A.
        • Bloch D.A.
        • Nelson L.M.
        Incidence of Parkinson's disease: variation by age, gender, and race/ethnicity.
        Am. J. Epidemiol. 2003; 157: 1015-1022
        • Dahodwala N.
        • Siderowf A.
        • Xie M.
        • Noll E.
        • Stern M.
        • Mandell D.S.
        Racial differences in the diagnosis of Parkinson's disease.
        Mov. Disord. 2009; 24: 1200-1205
        • Schneider M.G.
        • Swearingen C.J.
        • Shulman L.M.
        • Ye J.
        • Baumgarten M.
        • Tilley B.C.
        Minority enrollment in Parkinson's disease clinical trials.
        Park. Relat. Disord. 2009; 15: 258-262
        • Askew R.L.
        • Cook K.F.
        • Revicki D.A.
        • Cella D.
        • Amtmann D.
        Evidence from diverse clinical populations supported clinical validity of PROMIS pain interference and pain behavior.
        J. Clin. Epidemiol. 2016; 73: 103-111
        • Hill E.J.
        • Mangleburg C.G.
        • Alfradique-Dunham I.
        • Ripperger B.
        • Stillwell A.
        • Saade H.
        • Rao S.
        • Fagbongbe O.
        • vonCoelln R.
        • Tarakad A.
        • Hunter C.
        • Dawe R.
        • Jankovic J.
        • Shulman L.M.
        • Buchman A.S.
        • Shulman J.M.
        Quantitative mobility measures complement the MDS-UPDRS for characterization of Parkinson's disease heterogeneity.
        medRxiv. 2020; : 1-19
        • Falvo M.J.
        • Schilling B.K.
        • Earhart G.M.
        Parkinson's disease and resistive exercise: rationale, review, and recommendations.
        Mov. Disord. Off. J. Mov. Disord. Soc. 2008; 23: 1-11
        • Fullard M.E.
        • Thibault D.P.
        • Hill A.
        • Fox J.
        • Bhatti D.E.
        • Burack M.A.
        • Dahodwala N.
        • Haberfeld E.
        • Kern D.S.
        • Klepitskava O.S.
        • Urrea-Mendoza E.
        • Myers P.
        • Nutt J.
        • Rafferty M.R.
        • Schwalb J.M.
        • Shulman L.M.
        • Willis A.W.
        • Parkinson Study Group Healthcare O.
        • Disparities Working G.
        Utilization of rehabilitation therapy services in Parkinson disease in the United States.
        Neurology. 2017; 89: 1162-1169
        • Chan A.K.
        • McGovern R.A.
        • Brown L.T.
        • Sheehy J.P.
        • Zacharia B.E.
        • Mikell C.B.
        • Bruce S.S.
        • Ford B.
        • McKhann G.M.
        2nd, Disparities in access to deep brain stimulation surgery for Parkinson disease: interaction between African American race and Medicaid use.
        JAMA Neurol. 2014; 71: 291-299
        • Willis A.W.
        • Schootman M.
        • Kung N.
        • Evanoff B.A.
        • Perlmutter J.S.
        • Racette B.A.
        Predictors of survival in patients with Parkinson disease.
        Arch. Neurol. 2012; 69: 601-607
        • Werry A.E.
        • Daniel M.
        • Bergstrom B.
        Group differences in normal neuropsychological test performance for older non-Hispanic White and Black/African American adults.
        Neuropsychology. 2019; 33: 1089-1100
        • Diaz-Venegas C.
        • Downer B.
        • Langa K.M.
        • Wong R.
        Racial and ethnic differences in cognitive function among older adults in the USA.
        Int. J. Geriatr. Psychiatr. 2016; 31: 1004-1012
        • Tilley B.C.
        • Mainous 3rd, A.G.
        • Elm J.J.
        • Pickelsimer E.
        • Soderstrom L.H.
        • Ford M.E.
        • Diaz V.A.
        • Siminoff L.A.
        • Burau K.
        • Smith D.W.
        A randomized recruitment intervention trial in Parkinson's disease to increase participant diversity: early stopping for lack of efficacy.
        Clin. Trials. 2012; 9: 188-197