Objective: To examine sex differences in non-motor symptoms such as cognitive impairment, depression, anxiety, hallucinations, disease severity (Hoehn & Yahr scale), and sleep disorders in patients with Parkinson’s disease (PD).

Background: PD is a neurodegenerative disorder characterized by motor and non-motor symptoms, including cognitive decline, depression, anxiety, and sleep disturbances [1]. Studies suggest sex differences in PD, with women experiencing more severe non-motor symptoms and later disease onset, while men show faster cognitive decline and earlier motor symptoms [2][3]. This study aims to compare non-motor symptoms between sexes to assess significant differences.

Method: Participants were recruited through the Mexican Parkinson’s Research Network (MEX-PD). We assessed 276 PD patients, equally divided by sex (138 per group), using the Movement Disorder Society-Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) Parts I and III and the Hoehn & Yahr scale. Nearest neighbor matching using R (R version 4.4.2) adjusted for age in both male and female groups. Statistical analyses included the Wilcoxon rank-sum test, Chi-square test (>2 indicating symptom presence), and linear regression, examining education level, sleep disorders, and disease progression.

Results: The Wilcoxon rank-sum and Chi-square tests showed no significant sex differences in cognitive impairment, depression, anxiety, hallucinations, or sleep disorders (p > 0.05). However, disease severity, measured by the Hoehn & Yahr scale, differed significantly (Wilcoxon p = 0.014, Chi-square p = 0.017), suggesting different progression rates between sexes. Linear regression indicated sleep disorders and disease progression were associated with higher depression levels. Anxiety was significantly related to disease progression, sleep disorders, and education level, but not sex. This suggests non-motor symptom burden is influenced more by disease severity than sex.

Conclusion: Our findings suggest sex has little impact on non-motor symptom prevalence in PD, with disease severity playing a larger role. While no major sex-related differences were observed, disease progression correlated with sleep disorders, depression, and anxiety. Future research should further explore disease severity’s influence on non-motor symptoms and tailor treatment accordingly.

PD Patients by Sex (Wilcoxon Rank-Sum)

Non-Motor Symptom Analysis by Sex

References: 1. Josephson, S.A. (2010). Harrison´s Neurology in Clinical Medicine (Second Edition ed., Vol. Derived from Harrison´s Principles of Internal Medicine, 17th Edition.). Stephen L. Hauser.

2. ER, D., T, H., MS, O., & BR, B. (2018). The Emerging Evidence of the Parkinson Pandemic (1st ed.). J Parkinsons Dis.

3. Jagadeesan AJ, Murugesan R, Vimala Devi S, et al (2017). Current trends in etiology, prognosis and therapeutic aspects of Parkinson’s disease: a review. PubMed. https://pubmed.ncbi.nlm.nih.gov/29083328/

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MDS Abstracts - https://www.mdsabstracts.org/abstract/the-role-of-sex-in-cognitive-impairment-depression-anxiety-hallucinations-disease-severity-and-sleep-disorder-symptoms-in-parkinsons-disease-a-mexican-cohort-study/