Sex differences in Parkinson's disease presentation and progression

Area of Science:

• Neurology
• Clinical Research
• Sex Differences in Disease

Background:

• Females exhibit a lower incidence of Parkinson's disease (PD).
• The prognostic impact of sex in PD progression remains incompletely understood.
• Existing research lacks comprehensive analysis of sex-based differences in PD patient experience.

Purpose of the Study:

• To investigate sex-based disparities in the clinical presentation of Parkinson's disease.
• To compare physician- and patient-reported outcomes and disease progression between male and female PD patients.
• To identify potential drivers of observed sex differences in PD patient experience.

Main Methods:

• Secondary analysis of a large clinical cohort of Parkinson's disease patients.
• Examination of sociodemographic, clinical characteristics, treatment, and outcomes stratified by sex.
• Utilized five-year piecewise linear mixed-effects models to assess sex differences in progression of impairment, disability, and health-related quality of life (HRQoL).
• Employed mediation analysis to explore underlying factors influencing sex differences.

Main Results:

• The cohort comprised 914 males and 549 females.
• Females reported significantly lower social support, higher psychological distress, and worse self-reported disability and HRQoL at initial visits compared to males.
• Physician-reported outcomes did not show significant sex differences.
• Parkinson's disease progression rates were found to be minimal between sexes.

Conclusions:

• Parkinson's disease progression is not significantly influenced by sex.
• Females experience a greater burden of disease severity, as indicated by patient-reported measures.
• Implementing psychological distress screening and management, particularly for females, is recommended to mitigate disparities in PD patient experience.