Among those living with Parkinson’s disease, Black, Hispanic and Asian people had a lower health-related quality of life than White people, according to a new study published in Neurology, the medical journal of the American Academy of Neurology.

Health-related quality of life measures a person’s level of comfort, health, and happiness.

“Racial and ethnic minorities have been underrepresented in Parkinson’s disease research, which has limited our understanding of treatments and outcomes across these populations,” said study author Daniel Di Luca, MD, of the University of Toronto in Canada. “Previous research has shown that some populations may have limited access to neurologists, medications, and other therapies. Our study found that Black, Hispanic, and Asian people with Parkinson’s do have a lower quality of life than White people and that some health disparities and management differences persist even with ongoing expert neurologist care.”

The study involved 8,514 people with Parkinson’s disease; 90% were White, 6% were Hispanic, 2% were Asian, and 2% were Black.

Researchers asked participants to complete a questionnaire to evaluate their quality of life. It included 39 questions on how often participants experienced difficulty with daily tasks such as housework, cooking, and getting around in public during the past month.

It also asked how often they felt anxious, depressed, ignored by others, or unable to communicate properly. Participants answered each question using a five-point scale, with zero representing never and four representing always. The higher the score, the worse the quality of life.

After adjusting for factors such as age, sex, and disease duration as well as medical conditions such as diabetes and high blood pressure, the total average score was 29 for Black people, 27 for Hispanic people, 25 for Asian people, and 23 for White people. When looking at responses to various questions, scores for mobility, emotional well-being, social support, and pain were also worse for Black, Hispanic, and Asian people than for White people.

The researchers found that thinking and memory tests accounted for some differences in quality-of-life scores between Black, Hispanic, Asian, and white people. Di Luca noted that previous studies had shown lower socioeconomic status, education, and other psychological stressors may be associated with worse cognitive scores. In addition, cultural biases have also been shown to potentially influence the results of cognitive testing.

“Evaluating the underlying reasons behind differences in quality of life between racial and ethnic groups is crucial to improve care,” said Di Luca. “Future studies are needed to gain a better understanding of the reasons for treatment and outcome differences in underrepresented populations, including differences in thinking and memory, clinical care and quality of life.”

A limitation of the study was the small number of people in the non-white, non-Hispanic groups, which Marras said limited researchers’ ability to detect small but potentially significant differences. The study was supported by the Parkinson’s Foundation and the Parkinson’s Outcomes Project.

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