Publications by authors named "Nabila Dahodwala"
Article Synopsis
- The study investigates healthcare utilization and costs during the end-of-life period for Medicare beneficiaries with neurodegenerative diseases (like Alzheimer’s, Parkinson’s, and ALS) compared to those with cancer, specifically malignant brain tumors and pancreatic cancer.
- Researchers analyzed 2018 data, looking at demographics, clinical characteristics, and healthcare service usage over the final year of life, focusing particularly on emergency department visits, hospitalizations, and hospice care.
- Results showed that individuals with neurodegenerative diseases were generally older and more reliant on Medicaid, had higher odds of emergency department use but lower hospitalization rates compared to cancer patients, with overall healthcare costs primarily driven by inpatient care.
Article Synopsis
- - Anxiety and depression are common yet often overlooked symptoms in Parkinson's disease (PD), negatively affecting patients' functional outcomes over time.
- - A study of 490 participants showed that those with anxiety and depression had lower functional scores and higher disease severity scores, and anxiety specifically led to a quicker start of dopamine therapy.
- - Treating anxiety and depression in PD patients was linked to better health outcomes, including reduced medication dosages and improved functional scores, emphasizing the importance of recognizing and addressing these mental health issues.
Article Synopsis
- Recent research aimed to reevaluate the long-term risk of dementia in Parkinson's disease, using data from two large studies: PPMI and a cohort at the University of Pennsylvania.
- The study assessed 417 participants from PPMI and 389 from the Penn cohort, analyzing dementia diagnoses over time using various cognitive assessments.
- Results showed that by 10 years post-Parkinson's diagnosis, dementia probabilities were significantly lower than the previously cited 80%, with only 9-15% in the PPMI group and 47% diagnosed in the Penn cohort.
Improving Parkinson's Disease Care through Systematic Screening for Depression.
Mov Disord Clin Pract
October 2024
Background: Depression is common in Parkinson's disease (PD) but is underrecognized clinically. Although systematic screening is a recommended strategy to improve depression recognition in primary care practice, it has not been widely used in PD care.
Methods: The 15-item Geriatric Depression Scale (GDS-15) was implemented at 5 movement disorders clinics to screen PD patients.
Observational studies in Parkinson's disease (PD) deeply characterize relatively small numbers of participants. The Molecular Integration in Neurological Diagnosis Initiative seeks to characterize molecular and clinical features of every PD patient at the University of Pennsylvania (UPenn). The objectives of this study are to determine the feasibility of genetic characterization in PD and assess clinical features by sex and GBA1/LRRK2 status on a clinic-wide scale.
View Article and Find Full Text PDFBackground: Impairment in goal-directed behavior (GDB) contributes to apathy, a prevalent syndrome in Parkinson's disease (PD). The Philadelphia Apathy Computerized Task (PACT) is a performance-based measure of GDB that may be less confounded by reduced patient insight, cognitive impairment, and care partner burnout.
Objective: To examine how the PACT is related to patient function and care partner burden.
Ethnoracial differences for caregiving burden in Parkinson's disease.
Parkinsonism Relat Disord
January 2024
Introduction: Caregivers play an important role in Parkinson's disease (PD) treatment, especially as the disease progresses. As the symptom profile and needs of people with PD (PwP) differ across ethnoracial groups, whether caregiving needs also differ for different ethnoracial groups should be investigated.
Methods: Data were obtained from the Parkinson's Foundation funded Parkinson's Outcomes Project for PwP identifying as Hispanic (n = 495), non-Hispanic Asian (n = 170), non-Hispanic Black (n = 162), or non-Hispanic White (n = 7687).
Unique characteristics of end-of-life hospitalizations in Parkinson disease.
Front Aging Neurosci
October 2023
Introduction: Persons with Parkinson disease (PD) are hospitalized at higher rates, have longer lengths of stay, and are more likely to die in the hospital than age-matched peers. Although prior studies have compared inpatient outcomes between persons with and without PD, little is known about inpatient outcomes across the PD trajectory, or whether hospitalizations occurring in the last 6 months of life differ from earlier hospitalizations.
Methods: This cross-sectional study compared Medicare Part A and B beneficiaries aged 65 and older with a qualifying PD diagnosis who were hospitalized in 2017: decedents who died between 7/1/2017 and 12/31/2017 from all causes and were hospitalized at least once in their last 6 months of life, and non-decedents who were hospitalized between 1/1/2017 and 6/30/2017 and lived 6 or more months after discharge.
Parkinson's disease (PD) causes unique motor and non-motor symptoms. Despite symptomatic treatment with pharmacotherapies, many persons with PD report feelings of loneliness and demoralization as their disease progresses. These symptoms greatly interfere with quality of life, necessitating novel treatment strategies.
View Article and Find Full Text PDFImportance: Caregivers are integral to Parkinson disease (PD) care, but little information exists regarding how caregivers impact patient outcomes.
Objective: To assess the association between caregivers reporting depression symptoms and patient quality of life (QOL), emergency department (ED) visits, and hospitalizations.
Design, Setting, And Participants: This retrospective cohort study was conducted at 15 Parkinson's Foundation Centers of Excellence within the US.
Background: Integrated care is essential for improving the management and health outcomes for people with Parkinson's disease (PD); reliable and objective measures of care integration are few.
Objective: The aim of this study was to test the psychometric properties of the Rainbow Model of Integrated Care Measurement Tool (RMIC-MT, provider version) for healthcare professionals involved in PD care.
Methods: A cross-sectional survey was administered online to an international network representing 95 neurology centers across 41 countries and 588 healthcare providers.
Background: Since the onset of the coronavirus disease 2019 pandemic, the caregiving routine for care partners of people with Parkinson's disease (PwPD) changed substantially.
Objectives: To understand the nature and severity of burden in care partners of PwPD during the ongoing pandemic. We also sought to describe care partners' perceived change in burden and factors associated with increased burden.
Article Synopsis
- Health disparities in Parkinson disease (PD) highlight significant racial and ethnic differences in diagnosis, treatment, and research participation, which affect health outcomes and limit research applicability.
- A comprehensive review for the Michael J. Fox Foundation addresses these disparities across epidemiology, etiology, phenotype and diagnosis, treatment, and research.
- The report also outlines existing knowledge gaps and proposes policy changes aimed at ensuring equitable care for all individuals with PD, potentially serving as a framework for addressing disparities in other neurological diseases.
Background And Objectives: Racial and ethnic minorities have been underrepresented in Parkinson disease (PD) research, limiting our understanding of treatments and outcomes across all non-White groups. The goal of this research is to investigate variability in health-related quality of life (HRQoL) and other outcomes in patients with PD across different races and ethnicities.
Methods: This was a retrospective, cross-sectional and longitudinal, cohort study of individuals evaluated at PD Centers of Excellence.
Background And Objectives: To describe the prevalence of high adverse childhood experiences (ACEs) among neurology outpatients and determine their association with health care utilization rates and comorbid medical and psychiatric disease.
Methods: This was a cross-sectional study of adults seen for outpatient neurology follow-up at the University of Pennsylvania. Participants completed the ACE questionnaire and depression/anxiety screenings.
Motor features of Parkinson's disease (PD) are heterogeneous and well-studied; non-tremor features of postural instability and gait dysfunction (PIGD) have been linked to worse outcomes and Alzheimer's disease (AD) co-pathology. However, these features are understudied in Lewy body dementias (LBD). Here we perform retrospective analysis of a unique cohort of LBD (n = 30) with Unified Parkinson's Disease Rating Scale (UPDRS) data collected at baseline in proximity to cerebrospinal fluid collection to test the hypothesis that LBD patients with a positive AD biomarker profile (LBD + AD = 13) would have higher PIGD burden compared with LBD patients without AD biomarker positivity (LBD-AD = 17).
View Article and Find Full Text PDFBackground: Investigation of sex-related motor and non-motor differences and biological markers in Parkinson's disease (PD) may improve precision medicine approach.
Objective: To examine sex-related longitudinal changes in motor and non-motor features and biologic biomarkers in early PD.
Methods: We compared 5-year longitudinal changes in de novo, untreated PD men and women (at baseline N = 423; 65.
Background: Care partners support people with Parkinson's disease through a long journey ranging from independence to dependence for many daily tasks. Longitudinal studies are important to understand the evolution of this process and predictors of future needs of care partners.
Methods: A scoping review was conducted, searching PubMed for longitudinal studies examining care partner burden, needs or coping in Parkinson's disease published through May 2020.
Objective: To determine whether patients with Lewy body dementia (LBD) with likely Alzheimer disease (AD)-type copathology are more impaired on confrontation naming than those without likely AD-type copathology.
Methods: We selected 57 patients with LBD (dementia with Lewy bodies [DLB], n = 38; Parkinson disease dementia [PDD], n = 19) with available AD CSF biomarkers and neuropsychological data. CSF β-amyloid (Aβ), phosphorylated-tau (p-tau), and total-tau (t-tau) concentrations were measured.
Background: Observational studies in Parkinson's disease (PD) have focused on relatively small numbers of research participants who are studied extensively. The Molecular Integration in Neurological Diagnosis Initiative at the University of Pennsylvania aims to characterize molecular and clinical features of PD in every patient in a large academic center.
Objective: To determine the feasibility and interest in a global-capture biomarker research protocol.
Background: A composite measure that assesses both cognitive and functional abilities in Parkinson's disease (PD) would be useful for diagnosing mild cognitive impairment (MCI) and PD dementia (PDD) and as an outcome measure in randomized controlled trials. The Clinical Dementia Rating Scale Sum of Boxes (CDR-SOB) was designed to assess both cognition and basic-instrumental activities of daily living in Alzheimer's disease but has not yet been validated in PD.
Objective: To validate the CDR-SOB as a composite cognitive-functional measure for PD patients, as well as to assess its sensitivity to change.
Background: Increasing doses of oral antiparkinson medications are indicated in advanced Parkinson's disease (PD), but little is known about sustainment of high-dose regimens.
Objective: To investigate sustainment of high-dose oral medication regimens in Medicare beneficiaries with incident advanced PD.
Methods: This retrospective cohort study utilized 100%fee-for-service Medicare claims from 2011-2013.
Parkinson disease (PD) is highly prevalent among neurodegenerative diseases, affecting a diverse patient population. Despite a general willingness of patients to participate in clinical trials, only a subset of patients enroll in them. Understanding the barriers to trial participation will help to alleviate this discrepancy and improve trial participation.
View Article and Find Full Text PDFObjectives: To investigate the impact of Alzheimer's disease (AD) co-pathology on an in vivo structural measure of neurodegeneration in Lewy body disorders (LBD).
Methods: We studied 72 LBD patients (Parkinson disease (PD) = 2, PD-MCI = 25, PD with dementia = 10, dementia with Lewy bodies = 35) with either CSF analysis or neuropathological examination and structural MRI during life. The cohort was divided into those harboring significant AD co-pathology, either at autopsy (intermediate/high AD neuropathologic change) or with CSF signature indicating AD co-pathology (t-tau/Aβ > 0.