This project is investigating how socioeconomic inequality contributes to the heterogeneity of long-term clinical outcomes in patients with frontotemporal lobar degeneration disorders and Parkinson's Disease.
Background
Numerous studies have shown a relationship between socioeconomic deprivation and a higher risk of dementia, increased dementia mortality and a younger age at death with dementia. More recent studies have also shown a link between socioeconomic factors and care home admission in dementia (a proxy for functional independence). However, most of this research has focussed on Alzheimer’s disease or dementias in general. There is currently scant research on the effect of socioeconomic inequality on long term outcomes in the neurodegenerative diseases associated with frontotemporal lobar degeneration and Parkinson's disease.
Project Aims
This study aimed to determine if socioeconomic deprivation predicts long-term clinical outcomes in the neurodegenerative diseases associated with frontotemporal lobar degeneration and Parkinson's Disease in population of Cambridgeshire. The project investigated if deprivation predicts life expectancy, time to care home admission (a proxy for functional independence), and time to dementia.
Project Activity
Analyse existing data from established cohorts of patients living with these disorders in Cambridgeshire and Norfolk.
Anticipated or actual outputs
Determining whether socioeconomic deprivation contributes to the variation in outcomes is essential to understanding mechanisms, predicting prognosis and developing effective treatments and interventions for patients with frontotemporal lobar degeneration and Parkinson's Disease.
Findings
The project findings showed that living in an area of higher socioeconomic deprivation is not associated with shorter absolute survival in people with frontotemporal lobar degeneration syndromes (FTD, CBS, PSP) or Parkinson’s disease. In people with frontotemporal lobar degeneration syndromes, living in an area of higher deprivation was associated with shorter time to care home admission/death. In people with Parkinson’s disease, living in an area of higher deprivation was associated with a shorter time to dementia.
Impact
These results for absolute survival contrast with the effects reported for all-cause dementia and Alzheimer’s disease. Specialist services within universal healthcare coverage available for people with frontotemporal lobar degeneration syndromes and Parkinson’s disease may be helping to mitigate deprivation effects in absolute survival, but poor social care funding/policy drives people in deprived areas to move into care homes. There is an urgent need for better social care in the UK.
Next steps
That higher deprivation is associated with early care home admission is concerning and it is important to look deeper into the reasons for this. We aim to further investigate this deprivation effect to identify potential candidate mechanisms that are modifiable or treatable, by healthcare, social care and public policy.
Who was involved?
- Prof James Rowe
- Prof Caroline Williams-Gray
- Dr Anna Jane Dreyer
- Department of Clinical Neurosciences, University of Cambridge
