Diagnostic Challenges of Parkinson Disease in Under-Resourced Settings

Parkinson's Disease (PD) diagnosis in developing and low-resource settings is hampered by a mix of clinical, structural, and sociocultural factors that produce late, missed, or incorrect diagnoses. This ambiguity is exacerbated in poor- and Middle-Income Countries (LMICs) by a lack of neurologists and movement-disorder experts, limited access to specialized diagnostics and confirmatory imaging, poor public and primary-care awareness, and sociocultural obstacles that cause delays in presentation. The diagnostic gap is further exacerbated by poor referral systems, transportation and financial obstacles, and the misattribution of symptoms at the community level to aging or non-neurological reasons. Emerging solutions include task-shifting to trained primary-care workers, telemedicine, simplified clinical screening tools, and novel low-cost biomarkers such as blood-based assays. However, these require further validation and context-sensitive implementation.