Parkinson’s Disease – Leveraging the Epidemiology of the Disease to Develop Investigative Strategies & Improve Patient Outcomes

As the second most common neurodegenerative disorder, Parkinson’s Disease (PD) continues to emerge as a dominant public health issue among the elderly with cases of early on-set PD, although not as common, being of relevance to the development of intervention strategies.  The overall prevalence of PD is 1.8% of the population over the age of 65 years. (Ben-Shachar, 2017) Given the unknown etiology of PD, understanding the clinical presentation and epidemiological characteristics of men and women diagnosed with Parkinson’s Disease and data indicating gender differences is critical for diagnosing, devising treatment plans, outcome predictions, and identifying how to effectively meet the physical, mental, and social needs of this population.

A primary outcome measure for Parkinson’s Disease (PD) in clinical practice is quality of life (QoL). A chronic and progressive movement disorder, PD motor manifestations include resting tremor, rigidity, bradyhypokinesia, and postural instability. (Georgiev, 2017) Among the evidence in gender differences is that the onset of PD motor symptoms in women is later than men and they are also more likely to present with tremor-dominant PD. (Georgiev, 2017) The substantial evidence of disparities in diagnosing women across several disease modalities resulting in later diagnosis than men, as previously shared, underscore the need to continue research and identification of interventions that will improve these outcomes. While men have a significantly higher incidence rate and the relative risk is 1.5 times greater than women, women are likely to be diagnosed later, resulting in delayed treatment and advanced progression of the disease. Because the survival rate of women is often higher than men, women who become disabled because of PD are more likely to lack a spousal caregiver. (Balash, 2019) 

Strategies for investigating Parkinson’s Disease and improving patient outcomes should include researching evidence related to the use of an integrative healthcare approach to assist in identifying PD risk in women, early diagnosis, personalized medicine, and both short and long-term support to increase QoL outcomes. Furthermore, it is critical to investigate interventions that have been implemented to improve diagnosis and outcomes for the PD population, which strategies have been effective, and gaps that we may be able to address through a continuous improvement approach. Digging deeper to investigate not only the gender disparities, but any evidence of ethnic disparities that impact the outcomes for women with Parkinson’s Disease and systems approaches to tackle these inequities is also essential to mitigate advanced disease progression in these populations. 

References

Balash, Y., Korczyn, A. D., Migirov, A. A., & Gurevich, T. (2019). Quality of life in parkinson’s disease: A gender‐specific perspective. Acta Neurologica Scandinavica, 140(1), 17-22.  https://doi.org/10.1111/ane.13095

Ben-Shachar, S., Afawi, Z., Masalha, R., Badarny, S., Neiman, T., Pavzner, D., Bar-Shira, A., & Orr-Urtreger, A. (2017). Variable 0RW1S34RfeSDcfkexd09rT2PARK21RW1S34RfeSDcfkexd09rT2 mutations cause early-onset Parkinson’s disease in a small restricted population: MN. Journal of Molecular Neuroscience, 63(2), 216-222. https://doi.org/10.1007/s12031-017-0972-3

Georgiev, D., Hamberg, K., Hariz, M., Forsgren, L., & Hariz, G. ‐. (2017). Gender differences in parkinson’s disease: A clinical perspective. Acta Neurologica Scandinavica, 136(6), 570-584.  https://doi.org/10.1111/ane.12796