Clinical Characteristics and Predictors of Disease Progression in Parkinson's Disease in a Cohort of patients in the Ashanti Region, Ghana

• Data on Parkinson’s disease progression in sub-Saharan Africa are scarce • 161 Ghanaian patients with neurologist-confirmed Parkinson’s disease • 39% of participants were in mid-to-advanced Hoehn 114 males), 98 (60.9%) were in early-stage PD (H p = 0.003) but lower non-motor scores ( p < 0.001). Medication use was universal in mid-to-advanced stages vs 42.9% in early stages ( p = 0.001). Male patients, those who had lost employment due to PD, and those with moderate UPDRS severity were more likely to have mid-to-advanced disease, whereas higher income and urinary symptoms were less likely. Mixes of socio-demographic and clinical features are associated with mid-to-advanced stages of PD among this Ghanaian sample of PD patients. Integrating socioeconomic determinants into prognostic models may enable earlier identification of patients with mid-to-advanced PD and guide targeted interventions such as social support systems to improve their quality of life in resource-limited settings.