Cognitive Disparities in Parkinson's Disease

Disparities in Neurocognitive Impairment Among Hispanics/Latinos in the US With Parkinson's Disease: The Role of Cardiovascular Risk

This study will investigate disparities in neurocognitive impairment (NCI) among Hispanics/Latinos/as/x (henceforth Hispanics) living in the US-Mexico borderland of California or in North Carolina with Parkinson's Disease (PD) and determine mechanisms underlying these disparities. NCI is an important aspect of the clinical course of PD, particularly among Hispanics, who have increased prevalence of dementia. Among the many potential factors driving this disparity, the investigators chose to focus on a modifiable risk factor to which Hispanics are particularly vulnerable, and that has been linked to increased NCI, namely cardiovascular (CVD) risk (e.g., diabetes, hypertension, obesity).

Study Overview

• Status: Completed
• Conditions: Parkinson Disease
• Intervention / Treatment: Other: Will examine how Cardiovascular Disease risk, PD severity and social determinants impact neurocognitive impairment in Hispanics vs non-Hispanics Whites

Detailed Description

The proposed study will use a cross-sectional design to determine the presence of NCI in 120 persons with PD (age 40+), living in the US-Mexico borderland of California or in North Carolina, including 60 Hispanics and 60 non-Hispanic Whites. All participants will complete comprehensive neuromedical and neuropsychological evaluations, a blood draw and assessments of socio-cultural factors (e.g., health literacy, access to care, acculturation, bilingualism, discrimination, socioeconomic status). Using these data we will examine the extent to which CVD risk (e.g., diabetes, hypertension, obesity), PD severity and social determinants of health drive NCI among Hispanics with PD. The present proposal will capitalize on the infrastructure and expertise available at Duke University and will follow a community-based participatory research approach to complete the proposed study aims.

• Study Type: Observational
• Enrollment (Actual): 40

Contacts and Locations

Study Locations

• United States
  • California
    • La Jolla, California, United States, 92037
      • UC San Diego
  • North Carolina
    • Durham, North Carolina, United States, 27710
      • Duke University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Non-Probability Sample

Study Population

The proposed study will use a cross-sectional design to determine the presence of NCI in 120 persons with PD (age 40+), including 60 Hispanics and 60 non-Hispanic Whites living in the US/Mexico borderland of California or in North Carolina.

Description

Inclusion Criteria:

• 40 years old and older
• non-Hispanic Whites
• Hispanics
• All genders
• Ability to provide consent
• Diagnosed with Parkinson's Disease

Exclusion Criteria:

• Other neurological illness/diagnosis
• Injury that would affect cognition (i.e. stroke, closed head injury with loss of consciousness for longer than 30 minutes)

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Hispanics with Parkinson's Disease; All Hispanics with PD will complete comprehensive neuromedical and neuropsychological evaluations, a blood draw and assessments of socio-cultural factors (e.g., health literacy, access to care, acculturation, bilingualism, discrimination, socioeconomic status).	Other: Will examine how Cardiovascular Disease risk, PD severity and social determinants impact neurocognitive impairment in Hispanics vs non-Hispanics Whites; All participants will complete comprehensive neuromedical and neuropsychological evaluations, a blood draw and assessments of socio-cultural factors (e.g., health literacy, access to care, acculturation, bilingualism, discrimination, socioeconomic status).
non-Hispanic Whites with Parkinson's Disease; All non-Hispanic Whites with PD will complete comprehensive neuromedical and neuropsychological evaluations, a blood draw and assessments of socio-cultural factors (e.g., health literacy, access to care, acculturation, bilingualism, discrimination, socioeconomic status).	Other: Will examine how Cardiovascular Disease risk, PD severity and social determinants impact neurocognitive impairment in Hispanics vs non-Hispanics Whites; All participants will complete comprehensive neuromedical and neuropsychological evaluations, a blood draw and assessments of socio-cultural factors (e.g., health literacy, access to care, acculturation, bilingualism, discrimination, socioeconomic status).

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Language (Letter Fluency)		Day 1 (day of enrollment)
Language (Animal Fluency)		Day 1 (day of enrollment)
Language (Vegetable Fluency)		Day 1 (day of enrollment)
Language (Multilingual Naming Test)		Day 1 (day of enrollment)
Speed of Information Processing	Trail Making Test A	Day 1 (day of enrollment)
Speed of Information Processing	WAIS-III Digit Symbol	Day 1 (day of enrollment)
Speed of Information Processing	WAIS-III Symbol Search (Wechsler Adult Intelligence Scale)	Day 1 (day of enrollment)
Attention/Working Memory	PASAT-50 (Paced Auditory Serial Addition Test)	Day 1 (day of enrollment)
Attention/Working Memory	Number Span	Day 1 (day of enrollment)
Executive Function	Trail Making Test B	Day 1 (day of enrollment)
Executive Function	WCST-64 (Wisconsin Card Sorting Test)	Day 1 (day of enrollment)
Verbal Learning and Memory	Hopkins Verbal Learning Test-Revised	Day 1 (day of enrollment)
Verbal Learning and Memory	Craft Story Learning & Recall	Day 1 (day of enrollment)
Visual Learning and Memory	Brief Visuospatial Memory Test - Revised, Benson Figure Delay	Day 1 (day of enrollment)
Visual-Spatial skills	Benson Figure Copy	Day 1 (day of enrollment)
Everyday Functioning	Modified Lawton-Brody Instrumental Activities of Daily Living questionnaire	Day 1 (day of enrollment)
Diagnosis of MCI/dementia in PD	Objective presence of MCI and dementia in PD will be determined via comprehensive diagnostic criteria	Day 1 (day of enrollment)
diabetes mellitus	fasting plasma glucose >126 mg/dL, an HbA1c >6.5%, or use of antihyperglycemic medications	Day 1 (day of enrollment)
hypercholesterolemia and dyslipidemia	total cholesterol >240 mg/dL, LDL cholesterol >160 mg/dL, or HDL cholesterol <40 mg/dL or on cholesterol-lowering medication	Day 1 (day of enrollment)
hypertension	systolic blood pressure >140 mm Hg, diastolic blood pressure >90 mm Hg, or on antihypertensive medication	Day 1 (day of enrollment)
current cigarette smoking	Self-report	Day 1 (day of enrollment)
obesity	BMI of >30.0	Day 1 (day of enrollment)
Parkinson's disease severity	Movement Disorders Society-Sponsored Revision of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS)	Day 1 (day of enrollment)

Collaborators and Investigators

• Sponsor: Duke University
• Investigators: Principal Investigator: Maria J Marquine, PhD, Duke University

Publications and helpful links

General Publications

• Litvan I, Goldman JG, Troster AI, Schmand BA, Weintraub D, Petersen RC, Mollenhauer B, Adler CH, Marder K, Williams-Gray CH, Aarsland D, Kulisevsky J, Rodriguez-Oroz MC, Burn DJ, Barker RA, Emre M. Diagnostic criteria for mild cognitive impairment in Parkinson's disease: Movement Disorder Society Task Force guidelines. Mov Disord. 2012 Mar;27(3):349-56. doi: 10.1002/mds.24893. Epub 2012 Jan 24.
• Marquine MJ, Rivera Mindt M, Umlauf A, Suarez P, Kamalyan L, Morlett Paredes A, Yassai-Gonzalez D, Scott TM, Heaton A, Diaz-Santos M, Gooding A, Artiola I Fortuny L, Heaton RK, Cherner M. Introduction to the Neuropsychological Norms for the US-Mexico Border Region in Spanish (NP-NUMBRS) Project. Clin Neuropsychol. 2021 Feb;35(2):227-235. doi: 10.1080/13854046.2020.1751882. Epub 2020 May 20.

Helpful Links

• recruitment flyer - Spanish
• recruitment flyer - English
• Research Studies - Parkinson's Disease

Study record dates

Study Major Dates

• Study Start (Actual): September 30, 2022
• Primary Completion (Actual): December 31, 2025
• Study Completion (Actual): December 31, 2025

Study Registration Dates

• First Submitted: August 8, 2023
• First Submitted That Met QC Criteria: December 1, 2025
• First Posted (Estimated): December 4, 2025

Study Record Updates

• Last Update Posted (Actual): January 15, 2026
• Last Update Submitted That Met QC Criteria: January 14, 2026
• Last Verified: January 1, 2026

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Synucleinopathies; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Neurodegenerative Diseases; Movement Disorders; Parkinsonian Disorders; Basal Ganglia Diseases; Parkinson Disease
• Other Study ID Numbers: Pro00115158 (Other Identifier: Duke University Health System); 801968 (Other Identifier: UC San Diego)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: Study is conducted only at these sites, hence there is no need to share information with other investigators.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No