Sex-Specific Cognitive Divergence in Parkinson's Disease
Julia Saltyte Benth1,2, Gonzalo Sanchez Nido1,2,3, Kenn Freddy Pedersen4
1Neuro-SysMed, Department of Neurology, Haukeland University Hospital, 5021 Bergen, Norway.
Brain Sciences
|July 28, 2026
Summary
Parkinson's disease (PD) is linked to increasing sex differences in semantic fluency and processing speed, with males experiencing faster cognitive decline. These domain-specific changes highlight varying vulnerabilities in Parkinson's disease cognitive trajectories.
Area of Science:
- Neuroscience
- Neurology
- Cognitive Science
Background:
- Sex differences in cognitive impairment are reported in Parkinson's disease (PD), with males often showing greater decline.
- Existing research is largely cross-sectional, limiting understanding of long-term cognitive trajectories in PD.
- Longitudinal data is crucial for elucidating sex-specific progression in cognitive domains.
Purpose of the Study:
- To investigate sex-specific longitudinal cognitive changes over 9 years in idiopathic PD.
- To compare cognitive trajectories in persons with PD (PwPs) against age- and sex-matched controls.
- To identify specific cognitive domains affected by sex-specific decline in PD.
Main Methods:
- Analysis of prospective data from the ParkWest study (n=190 PwPs, n=202 controls).
- Assessment of semantic fluency, processing speed, cognitive control, memory, and visuospatial ability over 9 years.
- Linear mixed-effect models tested for time, disease status, and sex interactions, adjusted for covariates.
Main Results:
- Male PwPs exhibited a faster decline in most cognitive measures compared to female PwPs.
- Statistically significant sex-specific declines, compared to controls, were observed in semantic fluency and processing speed.
- These findings persisted after adjusting for age, education, depression, and UPDRS Part II scores.
Conclusions:
- Parkinson's disease is associated with widening sex differences in semantic fluency and processing speed, primarily due to accelerated decline in males.
- Cognitive trajectories in PD show domain-specific sex differences, not a generalized divergence.
- Understanding these domain-specific vulnerabilities is key for targeted interventions in PD.
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