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Burden of Parkinsonism and Parkinson's Disease on Health Service Use and Outcomes in Latin America

Lookup NU author(s): Professor Matthew Prina

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This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


Abstract

© 2023 - The authors. Published by IOS Press.Background: Little is known about the burden of parkinsonism and Parkinson's disease (PD) in Latin America. Better understanding of health service use and clinical outcomes in PD is needed to improve its prognosis. Objective: The aim of the study was to estimate the burden of parkinsonism and PD in six Latin American countries. Methods: 12,865 participants aged 65 years and older from the 10/66 population-based cohort study were analysed. Baseline assessments were conducted in 2003-2007 and followed-up 4 years later. Parkinsonism and PD were defined using current clinical criteria or self-reported diagnosis. Logistic regression models assessed the association between parkinsonism/PD with baseline health service use (community-based care or hospitalisation in the last 3 months) and Cox proportional hazards regression models with incident dependency (subjective assessment by interviewer based on informant interview) and mortality. Separate analyses for each country were combined via fixed effect meta-analysis. Results: At baseline, the prevalence of parkinsonism and PD was 7.9% (n = 934) and 2.6% (n = 317), respectively. Only parkinsonism was associated with hospital admission at baseline (OR 1.89, 95% CI 1.30-2.74). Among 7,296 participants without dependency at baseline, parkinsonism (HR 2.34, 95% CI 1.81-3.03) and PD (2.10, 1.37-3.24) were associated with incident dependency. Among 10,315 participants with vital status, parkinsonism (1.73, 1.50-1.99) and PD (1.38, 1.07-1.78) were associated with mortality. The Higgins I2 tests showed low to moderate levels of heterogeneity across countries. Conclusions: Our findings show that older people with parkinsonism or PD living in Latin America have higher risks of developing dependency and mortality but may have limited access to health services.


Publication metadata

Author(s): Kim DJ, Rodriguez-Salgado AM, Llibre-Rodriguez JJ, Acosta I, Sosa AL, Acosta D, Jimenez-Velasquez IZ, Guerra M, Salas A, Jeyachandran C, Lopez-Contreras R, Hesse H, Tanner C, Llibre-Guerra JJ, Prina M

Publication type: Article

Publication status: Published

Journal: Journal of Parkinson's Disease

Year: 2023

Volume: 13

Issue: 7

Pages: 1199-1211

Online publication date: 03/11/2023

Acceptance date: 25/08/2023

Date deposited: 27/11/2023

ISSN (print): 1877-7171

ISSN (electronic): 1877-718X

Publisher: IOS Press BV

URL: https://doi.org/10.3233/JPD-230114

DOI: 10.3233/JPD-230114

Data Access Statement: The data supporting the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.

PubMed id: 37742660


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Funding

Funder referenceFunder name
FONACIT/ CDCH/ UCV
GR066133
GR080002
K01AG073526
Health Consequences of Population Change Program
Michael J. Fox Foundation
MJFF-020770
NIH-NIA
US Alzheimer’s Association
Wellcome Trust
World Health Organization

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