Parkinson's disease in the United Arab Emirates (UAE): Emirates Neurology Society consensus guidelines
Abstract
Background: Parkinson's disease (PD) incidence has risen by more than eightfold in the United Arab Emirates (UAE) between 1990 and 2019, representing one of the highest increases globally and creating substantial pressure on a fragmented, multi-payer health system. Region-specific guidance has been lacking, leading clinicians to extrapolate from international guidelines that do not fully address formulary heterogeneity, advanced therapy centralization, and cultural factors.
Methods: Under the auspices of the Emirates Neurology Society, a national taskforce of 10 specialists representing major PD centers across the UAE used a three-round modified Delphi process informed by systematic literature review and key randomized controlled trials. Recommendations were graded using a GRADE-aligned system (A-C, Good Practice Points) and adapted to UAE formulary, service configuration, and cultural context.
Results: Consensus was achieved on 146 recommendations across eight domains: (1) mandatory adoption of MDS-2015 diagnostic criteria; (2) age-stratified pharmacologic algorithms with levodopa as first-line for older or cognitively vulnerable patients; (3) structured non-motor symptom management; (4) rehabilitation and UAE cultural lifestyle adaptations including Ramadan fasting management, DBS considerations in women, family-centered care, and multilingual practice; (5) advanced therapy referral using the 5-2-1 rule integrated with the Making Informed Decisions to Aid Timely Management…
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