Knowledge Gaps on Treating Women With Parkinson Disease: Indu Subramanian, MD

The director of the VA Southwest Parkinson’s Disease Research, Education, and Clinical Centers and clinical professor of neurology at UCLA discussed the lack of a more focused and specific approach to care for women with Parkinson disease. [WATCH TIME: 6 minutes]

WATCH TIME: 6 minutes

“If you think about the ER doctor or whoever is seeing that patient in an urgent care who might be the only point of care, they’re not thinking that someone that looks like me could have Parkinson if they walk in with the types of symptoms that are very classic. The disease awareness and the societal thinking about who has Parkinson has really got to change.”

Parkinson disease (PD) treatment has advanced fairly rapidly in the last decade, though there are still challenges that persist in the paradigm of care for this patient population. One of the major obstacles to improving this state of care has been the lack of awareness about the patient population themselves. The picture that many clinicians outside of movement disorder specialists hold of the typical patient with PD—and the one displayed in many medical textbooks—can be outdated, as many can recall an image of an elderly White man. This is in contrast with the much wider variety of individuals with PD, including women, minorities, and those who are younger in age.

A recent paper published by Indu Subramanian, MD, and colleagues in Movement Disorders highlighted some of the disparities in the health care of women with PD, mainly pointing to the need to amplify the voices in this population to achieve true change in the paradigm of management.1 Subramanian noted that when patients—particularly younger ones—present to a nonspecialist setting, PD can often be left off the table as an option for diagnosis, even when patients present with the symptoms considered typical of the disease.

Subramanian, who is the director of the VA Southwest Parkinson’s Disease Research, Education, and Clinical Centers, and a clinical professor of neurology at the University of California, Los Angeles, explained in a conversation with NeurologyLive® that there is a major need to not only raise awareness about what this patient population looks like but also the symptoms that they can experience. PD is not solely a disease of motor function—there are nonmotor symptoms and comorbidity challenges that are common in PD and often more greatly affect patient quality of life.

Subramanian also touched on the need to improve clinical trials and the data that is reported in them, as often clinical trials exclude the nonideal patients and those who look more closely like real-world population. This can create challenges in determining which specific patient populations will benefit from certain treatment approaches or therapies.

1. Subramanian I, Mathur S, Oosterbaan A, Flanagan R, Keener AM, Moro E. Unmet Needs of Women Living with Parkinson’s Disease: Gaps and Controversies. Movement Dis. Published online January 20, 2022. doi:10.1002/mds.2892