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. 2019 Dec:69:48-54.
doi: 10.1016/j.parkreldis.2019.10.019. Epub 2019 Oct 23.

Sex differences in Parkinson's disease presentation and progression

Danielle S Abraham  1 , Ann L Gruber-Baldini  2 , Laurence S Magder  2 , Patrick F McArdle  3 , Sarah E Tom  4 , Erik Barr  2 , Katrina Schrader  5 , Lisa M Shulman  5
Affiliations

Sex differences in Parkinson's disease presentation and progression

Danielle S Abraham et al. Parkinsonism Relat Disord. 2019 Dec.

Abstract

Introduction: Females have a reduced risk of Parkinson's disease (PD). However, it is unclear if sex is a prognostic factor. We aimed to examine differences in presentation, physician- and patient-reported PD outcomes, and progression by sex in a large clinical cohort.

Methods: This study was a secondary analysis of a cohort of PD patients seen at a tertiary care center. Sociodemographic and clinical characteristics, treatment, care timing, and outcomes were examined by sex. Sex differences in progression of impairment, disability, and health-related quality of life (HRQoL) were tested with five-year piecewise linear mixed-effects models. A mediation analysis assessed drivers of sex differences.

Results: The study included 914 males and 549 females. Females had significantly less social support, more psychological distress, and worse self-reported (but not physician-reported) disability and HRQoL at initial PD care visits, compared to males. Addressing anxiety symptoms may attenuate this difference. PD progression sex differences were minimal.

Conclusion: PD progression does not differ by sex, yet patient-reported measures of disease severity are worse in females than males. To attenuate this sex difference in disease experience, psychological distress screening and management, particularly targeting females, should be implemented as part of PD clinical care.

Keywords: Activities of daily living; Parkinson's disease; Patient reported outcome measures; Quality of life; Sex differences.

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Conflict of interest statement

DECLARATION OF INTEREST

DSA, ALG-B, and SET received grant funding from National Institute on Aging during the conduct of the study. DSA received financial support from the Parkinson’s Foundation. LSM, PFM, EB, KS, and LMS have nothing to disclose.

Figures

Figure 1.
Figure 1.
Plot of average rate of Parkinson’s disease (PD) UPDRS Motor progression by sex
See this image and copyright information in PMC

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