Parkinson's through a cultural lens: Diversity in disease expression and care

Living and care experiences with Parkinson's disease (PD) vary widely across cultures. Global heterogeneity in PD disease expression is increasingly recognized, shaped by differences in genetic backgrounds, environmental exposures, socioeconomic conditions, and access to healthcare resources. Cultural beliefs, levels of health literacy, and stigma play a critical role in shaping how individuals perceive their illness and influence when and how they seek medical care, their trust in healthcare providers, acceptance of diagnosis, and adherence to recommended treatments. Stigma-both internalized and externally imposed-can lead to social withdrawal, delayed help-seeking, and reduced quality of life. Caregiving experiences are likewise deeply influenced by sociocultural norms, including collectivist versus individualist value systems, gendered expectations, and familial structures, all of which affect the distribution of caregiving responsibilities and perceived caregiver burden. These cultural and structural dimensions contribute to marked disparities in diagnosis, treatment, and long-term support for PD across different populations. To address these inequities, clinical care models must be reoriented to incorporate cultural competence training for healthcare providers, locally tailored public education campaigns to combat stigma, and the development of culturally congruent support systems for patients and families. In parallel, future research must prioritize the inclusion of underrepresented populations and sociocultural contexts in epidemiological studies, clinical trials, and implementation science. Advancing culturally responsive, person-centered models of PD care is essential to dismantling structural barriers, reducing disparities, and promoting equitable outcomes for all people living with PD-regardless of geography, ethnicity, or cultural background.