Hoehn and Yahr Stage and Non-Motor Symptom Burden in Parkinson's Disease: A Cross-Sectional Study in Peru

Background and Objectives: Parkinson's disease is a multidimensional neurodegenerative disorder in which motor and non-motor manifestations frequently coexist. This study aimed to evaluate the association between Hoehn and Yahr stage and non-motor symptom burden among patients with Parkinson's disease in Peru. Materials and Methods: An analytical cross-sectional study was conducted in 92 patients with Parkinson's disease registered or followed at Hospital San Juan Bautista de Huaral, Lima region, Peru, during 2025. Non-motor symptom burden was assessed using MDS-UPDRS Part I and categorized as mild, moderate, or severe. Clinical stage was assessed using the Hoehn and Yahr scale and grouped as early, intermediate, or advanced. Crude and adjusted ordinal odds ratios (ORs) with 95% confidence intervals (CIs) were estimated using ordinal logistic regression. Results: The median age was 65.0 years, 67.4% were male, and the median disease duration was 6.0 years. Moderate and severe non-motor symptoms were observed in 58.7% and 23.9% of patients, respectively. In the adjusted model, intermediate stage (adjusted OR = 5.89; 95% CI: 1.83-18.98) and advanced stage (adjusted OR = 27.74; 95% CI: 6.74-114.18) were associated with greater non-motor symptom severity. Conclusions: Higher Hoehn and Yahr stage was independently associated with greater non-motor symptom severity. These findings support systematic non-motor assessment, particularly in intermediate and advanced stages.