Sex-related differences in homebound advanced Parkinson’s disease patients

Sex-related differences in homebound advanced Parkinson’s disease patients

Lynda Nwabuobi,1 William Barbosa,2 Meghan Sweeney,3 Sarah Oyler,4 Talia Meisel,5 Alessandro Di Rocco,6 Joshua Chodosh,7,8 Jori E Fleisher91Department of Neurology, Movement Disorders Division, Columbia University Medical Center, New York, NY, USA; 2New York University School of Medicine, New York, N...

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Autores principales: Nwabuobi L, Barbosa W, Sweeney M, Oyler S, Meisel T, Di Rocco A, Chodosh J, Fleisher JE
Formato: article
Lenguaje:EN
Publicado: Dove Medical Press 2019
Materias:
Parkinsonism
gender disparities
caregiver
aging
health services
health disparities
Geriatrics
RC952-954.6
Acceso en línea:https://doaj.org/article/836ad15a09124f5899957c4e0a763a60
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spelling oai:doaj.org-article:836ad15a09124f5899957c4e0a763a602021-12-02T07:16:21ZSex-related differences in homebound advanced Parkinson’s disease patients1178-1998https://doaj.org/article/836ad15a09124f5899957c4e0a763a602019-07-01T00:00:00Zhttps://www.dovepress.com/sex-related-differences-in-homebound-advanced-parkinsons-disease-patie-peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998Lynda Nwabuobi,1 William Barbosa,2 Meghan Sweeney,3 Sarah Oyler,4 Talia Meisel,5 Alessandro Di Rocco,6 Joshua Chodosh,7,8 Jori E Fleisher91Department of Neurology, Movement Disorders Division, Columbia University Medical Center, New York, NY, USA; 2New York University School of Medicine, New York, NY, USA; 3Department of Palliative Care, Kaiser Permanente, Lafayette, CO, USA; 4Intermountain Neurosciences Institute, Intermountain Medical Center, Murray, UT, USA; 5State University of New York Downstate Medical Center College of Medicine, Brooklyn, NY, USA; 6Department of Neurology, Movement Disorders Division, Northwell Health, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Long Island, NY, USA; 7Division of Geriatric Medicine and Palliative Care, New York University Langone Health, New York, NY, USA; 8Veterans Affairs NY Harbor Healthcare System, NY, New York, USA; 9Section of Movement Disorders, Department of Neurological Sciences, Rush Medical College, Rush University, Chicago, IL, USABackground: Women with Parkinson’s disease (PD) are more likely to be older, have greater disease severity and comorbidities, and yet are less likely to receive care from a neurologist, as compared with men with PD. Within the PD population, homebound individuals are a particularly vulnerable group facing significant barriers to care, yet within this understudied population, sex-related differences have not been reported.Purpose: To identify and describe differences in homebound men and women with advanced PD and related disorders, participating in an interdisciplinary home visit program.Patients and methods: This was an exploratory analysis of homebound patients seen between February 2014 and July 2016 using data collected via in-person interviews and chart review.Results: We enrolled 85 patients, of whom 52% were women. PD was the most common diagnosis (79%), followed by dementia with Lewy bodies (5%), and other atypical parkinsonism (16%). Men were more likely to have a PD dementia diagnosis than women (17.1% vs 2.3%, p=0.03). Women were more likely to live alone (18.1% of women had no caregiver vs 2.4% of men, p=0.05).Conclusion: The role of the caregiver in facilitating safe aging-in-place is crucial. Among homebound individuals with advanced PD, women were far more likely to live alone. The absence of a spouse or care partner may be due in part to variable sex-based life expectancies. Our findings suggest that homebound women with advanced PD may face greater barriers to accessing support.Keywords: parkinsonism, gender disparities, caregiver, aging, health services, health disparitiesNwabuobi LBarbosa WSweeney MOyler SMeisel TDi Rocco AChodosh JFleisher JEDove Medical PressarticleParkinsonismgender disparitiescaregiveraginghealth serviceshealth disparitiesGeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 14, Pp 1371-1377 (2019)
institution DOAJ
collection DOAJ
language EN
topic Parkinsonism
gender disparities
caregiver
aging
health services
health disparities
Geriatrics
RC952-954.6
spellingShingle Parkinsonism
gender disparities
caregiver
aging
health services
health disparities
Geriatrics
RC952-954.6
Nwabuobi L
Barbosa W
Sweeney M
Oyler S
Meisel T
Di Rocco A
Chodosh J
Fleisher JE
Sex-related differences in homebound advanced Parkinson’s disease patients
description Lynda Nwabuobi,1 William Barbosa,2 Meghan Sweeney,3 Sarah Oyler,4 Talia Meisel,5 Alessandro Di Rocco,6 Joshua Chodosh,7,8 Jori E Fleisher91Department of Neurology, Movement Disorders Division, Columbia University Medical Center, New York, NY, USA; 2New York University School of Medicine, New York, NY, USA; 3Department of Palliative Care, Kaiser Permanente, Lafayette, CO, USA; 4Intermountain Neurosciences Institute, Intermountain Medical Center, Murray, UT, USA; 5State University of New York Downstate Medical Center College of Medicine, Brooklyn, NY, USA; 6Department of Neurology, Movement Disorders Division, Northwell Health, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Long Island, NY, USA; 7Division of Geriatric Medicine and Palliative Care, New York University Langone Health, New York, NY, USA; 8Veterans Affairs NY Harbor Healthcare System, NY, New York, USA; 9Section of Movement Disorders, Department of Neurological Sciences, Rush Medical College, Rush University, Chicago, IL, USABackground: Women with Parkinson’s disease (PD) are more likely to be older, have greater disease severity and comorbidities, and yet are less likely to receive care from a neurologist, as compared with men with PD. Within the PD population, homebound individuals are a particularly vulnerable group facing significant barriers to care, yet within this understudied population, sex-related differences have not been reported.Purpose: To identify and describe differences in homebound men and women with advanced PD and related disorders, participating in an interdisciplinary home visit program.Patients and methods: This was an exploratory analysis of homebound patients seen between February 2014 and July 2016 using data collected via in-person interviews and chart review.Results: We enrolled 85 patients, of whom 52% were women. PD was the most common diagnosis (79%), followed by dementia with Lewy bodies (5%), and other atypical parkinsonism (16%). Men were more likely to have a PD dementia diagnosis than women (17.1% vs 2.3%, p=0.03). Women were more likely to live alone (18.1% of women had no caregiver vs 2.4% of men, p=0.05).Conclusion: The role of the caregiver in facilitating safe aging-in-place is crucial. Among homebound individuals with advanced PD, women were far more likely to live alone. The absence of a spouse or care partner may be due in part to variable sex-based life expectancies. Our findings suggest that homebound women with advanced PD may face greater barriers to accessing support.Keywords: parkinsonism, gender disparities, caregiver, aging, health services, health disparities
format article
author Nwabuobi L
Barbosa W
Sweeney M
Oyler S
Meisel T
Di Rocco A
Chodosh J
Fleisher JE
author_facet Nwabuobi L
Barbosa W
Sweeney M
Oyler S
Meisel T
Di Rocco A
Chodosh J
Fleisher JE
author_sort Nwabuobi L
title Sex-related differences in homebound advanced Parkinson’s disease patients
title_short Sex-related differences in homebound advanced Parkinson’s disease patients
title_full Sex-related differences in homebound advanced Parkinson’s disease patients
title_fullStr Sex-related differences in homebound advanced Parkinson’s disease patients
title_full_unstemmed Sex-related differences in homebound advanced Parkinson’s disease patients
title_sort sex-related differences in homebound advanced parkinson’s disease patients
publisher Dove Medical Press
publishDate 2019
url https://doaj.org/article/836ad15a09124f5899957c4e0a763a60
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