Study Rationale: Brazil has enormous economic and social inequalities. Pesticides, heavy metals and other pollutants can contribute to the development of degenerative conditions such as Parkinson's disease (PD), which may go undiagnosed due to lack of access to neurologic care. This study will target four underserved Brazilian areas to better estimate the number of people with PD and to evaluate and implement strategies to improve access to neurologic care. Our ultimate goal is to influence public policies so that more people with PD can access specialized healthcare in Brazil and other countries with similar demographics.
Hypothesis: We will determine how many people in Brazil have PD and assess whether there is a link between environmental factors and PD onset and whether teleconsultations can be used to evaluate patients with PD in underserved areas.
Study Design: We will screen all people aged 60 and older from four underserved regions for PD. In areas without access to technology, the screening will be done by phone or door-to-door. Then, neurologists will examine those suspected of having PD or other similar conditions. Individuals with PD or similar conditions will be evaluated clinically. We will take blood samples for genetic testing and hair samples for heavy metal testing. Also, we will compare the efficacy of in-person and teleconsultations in diagnosing PD.
Impact on Diagnosis/Treatment of Parkinson’s Disease: Having a better estimate of the number of people with PD in the population and evaluating alternative options for access to care, such as teleconsultation, in underserved areas could allow for earlier detection and intervention.
Next Steps for Development: Estimating the number of people with PD in Brazil will help researchers, doctors, and policymakers understand the disease burden. Testing the use of teleconsultation for PD diagnosis and management will allow underserved communities to access care. Analyzing the influence of environmental factors on PD presentation may improve clinical practice and patient care.