Differences and contributors to global cognitive performance in the underrepresented Latinx Parkinson’s disease population

<b>Objective:</b> Despite significant progress in understanding the factors influencing cognitive function in Parkinson’s disease (PD), there is a notable gap in data representation for the Latinx population. This study aims to evaluate the contributors to and disparities in cognitive performance among Latinx patients with PD. <b>Methods:</b> A retrospective analysis was conducted based on cross-sectional data encompassing demographic, environmental, motor, and non-motor disease characteristics from the Latin American Research Consortium on the Genetics of PD (LARGE-PD) and the Parkinson’s Progression Markers Initiative (PPMI) cohorts. Linear regression multivariable models were applied to identify variables affecting Montreal Cognitive Assessment (MoCA) scores, accounting for age, sex, and years of education. <b>Results:</b> The analysis comprised of 3,054 PD patients (2,041 from LARGE-PD and 1,013 from PPMI) and 1,303 Latinx-controls. Latinx-PD patients (mean age 63.0 ± 11.8, 56.8% male) exhibited a significantly lower average MoCA score (<i>p</i> &lt; .001) compared to white Non-Hispanic PD patients from PPMI (mean age 67.5 ± 9.9, 61.7% male). This difference persisted when comparing the Latinx-PD to the Latinx-controls (mean age 58.7 ± 9.3, 33.2% male; <i>p</i> &lt; .001). Factors significantly associated with better MoCA scores in Latinx-PD included unilateral symptom onset (<i>p</i> = .009), and higher educational attainment (<i>p</i> &lt; .001). Conversely, those associated with worse scores included the use of dopamine agonists (<i>p</i> = .01), previous tobacco use (<i>p</i> = .01), older age (<i>p</i> &lt; .001), and a higher Hoehn and Yahr scale score (<i>p</i> &lt; .001). <b>Conclusions:</b> Latinx-PD patients demonstrated significantly lower cognitive scores compared to their white non-Hispanic PD counterparts and Latinx-controls. These results highlight the importance of interpreting MoCA scores in a nuanced manner within diverse populations.

**研究目标：** 尽管针对帕金森病（Parkinson’s Disease, PD）认知功能影响因素的研究已取得显著进展，但拉丁裔人群的数据代表性仍存在显著缺口。本研究旨在探究拉丁裔帕金森病患者认知表现的影响因素及相关差异。
**研究方法：** 本研究基于两项队列的横断面数据开展回顾性分析，数据涵盖人口学、环境学、运动及非运动疾病特征，数据来源为拉丁美洲帕金森病遗传学研究联盟（Latin American Research Consortium on the Genetics of PD, LARGE-PD）队列与帕金森病进展标志物倡议（Parkinson’s Progression Markers Initiative, PPMI）队列。本研究采用多元线性回归模型，以年龄、性别及受教育年限作为协变量，识别影响蒙特利尔认知评估量表（Montreal Cognitive Assessment, MoCA）评分的相关变量。
**研究结果：** 本次分析共纳入3054名帕金森病患者（其中2041名来自LARGE-PD队列，1013名来自PPMI队列）及1303名拉丁裔健康对照者。拉丁裔帕金森病患者的平均年龄为63.0±11.8岁，男性占比56.8%，其平均蒙特利尔认知评估量表评分显著低于PPMI队列中的非西班牙裔白人帕金森病患者（该组患者平均年龄67.5±9.9岁，男性占比61.7%，p<0.001）。将拉丁裔帕金森病患者与拉丁裔健康对照者（平均年龄58.7±9.3岁，男性占比33.2%，p<0.001）进行比较时，上述差异依然存在。在拉丁裔帕金森病患者中，与更高蒙特利尔认知评估量表评分显著相关的因素包括单侧症状起病（p=0.009）及更高的受教育程度（p<0.001）；反之，与更低评分相关的因素包括使用多巴胺受体激动剂（p=0.01）、既往吸烟史（p=0.01）、年龄更大（p<0.001）以及更高的霍恩-雅尔分期量表（Hoehn and Yahr scale）评分（p<0.001）。
**研究结论：** 拉丁裔帕金森病患者的认知评分显著低于非西班牙裔白人帕金森病患者及拉丁裔健康对照者。本研究结果提示，在多样化人群中解读蒙特利尔认知评估量表评分时，需采取精细化的考量方式。