Investigating Disparities in Counseling Parkinson's Disease Patients on Diet and Exercise in a Clinical Setting: An Examination of Gender, Race, Insurance Status, and Language Factors
Stefano Malerba1, Katherine Leaver2
1Neurology, Mount Sinai West/Beth Israel, 2Mount Sinai West/Beth Israel
Objective:

This study investigates potential disparities in the provision of diet and exercise counseling for Parkinson's disease (PD) patients, considering the influence of gender, race, insurance status, and language proficiency.

Background:
PD is a neurodegenerative disorder associated with diminished nutrition status and early disability. Emerging evidence suggests that diet plays a pivotal role in both prevention and management of PD symptoms in the same way physical therapy and exercise have been associated with improved function and reduced disability. Lifestyle interventions, such as diet and exercise counseling, are thus critical for improving disease course, though it has been shown that substantial disparities in counseling with respect to access to care, demographic and socioeconomic factors continue to exist.
Design/Methods:
A retrospective analysis was conducted on data from 100 PD patients who visited an academic movement disorder clinic (Mount Sinai Movement Disorders Center) between 2020-2023. Patient charts were randomly selected using a computer-generated randomization scheme. Demographic and socioeconomic information and records of diet and exercise counseling were collected. Chi-square/Fisher tests were employed to assess associations between demographic variables and the likelihood of receiving counseling.
Results:
The overall rate of counseling for diet was 23%, while the overall rate of exercise counseling was 93% (Table 1). Non-English speakers received a significantly higher rate of counseling (p=0.03). No other statistically significant association between counseling and demographic variables under investigation was noted.
Conclusions:
While no major associations between counseling and demographic or socioeconomic variables were identified, the low frequency of diet counseling highlights a gap in healthcare delivery, underscoring the need to prioritize diet counseling as a fundamental component of PD management in clinical practice. Given the evidence suggesting the pivotal role of diet in the prevention/management of PD, it is imperative to recognize the importance of diet counseling, as this can contribute to better outcomes and improved quality of life.
10.1212/WNL.0000000000204552