Objective:

To explore sex-specific differences in symptoms of prodromal Parkinson’s in the PREDICT-PD cohort

Background: Multiple lines of evidence suggest that biological sex is an important factor for the development of Parkinson’s disease (PD) and symptoms can vary between sexes. The risk of developing PD is higher in men than women and motor and non-motor symptoms differ between sexes. Symptoms such as hyposmia, REM sleep behavior disorder [RBD], depression and anxiety may occur decades before a PD diagnosis. Here, we investigated sex-specific differences in prodromal symptoms in higher risk individuals participating in PREDICT-PD

Method: PREDICT-PD is a population-based cohort of participants without PD aged 50-80 years at baseline that uses online tests and an algorithm to identify individuals at high risk of PD. Approximately 11,800 participants have enrolled in the study of which 1,834 participants have been identified as higher risk (i.e., not having PD and having scores in the highest 15th centile using the PREDICT-PD algorithm). In this group, sex differences for the prodromal symptoms of hyposmia, RBD, depression and anxiety, were evaluated with Fisher’s exact tests

Results: Only 302 (16.5%) of the highest risk group were women (compared with 6,722 participants [56.9%] in the entire cohort). A medical history of anosmia/hyposmia was more common among women than men (6.3% vs 2.4%, p=0.001). A similar distribution for self-reported medical history of RBD was observed (2.7% in women and 3.5% in men, p= 0.6003) but a positive answer to the RBD Single-Question Screen (RBD1Q) was more common in women than men (42.4% vs 35.2%, p=0.022). Similarly, depression and anxiety evaluated using the Hospital Anxiety and Depression Scale (HADS) showed that moderate/ severe levels of depression and anxiety were more common among women than men (9.6% vs 5.5% for depression and 7.5% vs 2.0% for anxiety, p=0.025 and p=0.026 respectively)

Conclusion: Biological sex appears to be an important factor in people at risk of PD, with overall, more men than women in the higher risk subgroup in our cohort. However, this was expected as male sex increases the estimated risk in the algorithm. Similar to manifest PD, women in the subgroup appear to experience more prodromal symptoms. Our findings highlight the impact of biological sex on PD within the prodromal stages. Larger and more diverse studies evaluating additional symptoms of prodromal PD are needed

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MDS Abstracts - https://www.mdsabstracts.org/abstract/sex-differences-in-prodromal-parkinsons-disease-pd/