The clinical profile of idiopathic Parkinson’s disease in a South African hospital complex - the influence of ethnicity and gender

Abstract

Background
Idiopathic Parkinson’s Disease (IPD) has not been well studied in Black African populations. Data on the
demographics, phenotype differences with Caucasoid populations, severity and frequencies of IPD in Black
Africans is scant.
Aim To determine the impact of ethnicity and gender on the phenotype of IPD in South African patients.
Method This was a hospital based study. One hundred and forty-six patients from the movement disorder clinics were screened. Fifty patients with IPD met the inclusion criteria. The data collection was in the form of a questionnaire and clinical evaluation which included a mental status examination (MMSE), and illness staging.
Results Thirty-five patients were Black African, eleven were of white European descendant, three were of Indian descent and one had mixed ancestry. Twenty-eight of the patients were female. There were no significant gender differences within or between the different ethnic groups. Seventy- one percent of Black and ninetyone percent of White participants had classic IPD presentations. A resting tremor was found in fifty-nine percent of all males in the study but in ninety-four percent of females. In the Black IPD patients, thirty one percent had early onset IPD (age of onset less than 50 years) with a gender ratio of M:F=1:6. Twenty nine percent had an akinetic-rigid syndrome with erect posture and no tremor (gender ratio of M:F = 7:4) and seventy four had cognitive impairment (gender ratio of M:F =8:5).
Conclusion The phenotype of IPD in the majority of our study population is of the classic IPD type. In a third of our Black patients the onset was early and in almost a third the presentation was akinetic. One of the main limitations was that the majority of the patients served by these hospitals are Black, making it difficult to recruit an adequate number of White patients.