Objective: To analyze sex differences in PD in a large cohort from a hospital specializing in PD and other movement disorders.

Background: Sex differences in disease are largely neglected despite their potential to improve our understanding of biology and pathophysiology, and their relevance to clinical trial outcomes in neurodegenerative disorders such as Parkinson’s disease (PD). These differences span multiple domains, including motor and non-motor symptoms, disease progression, treatment response, and quality of life. Despite the importance of this topic, large-scale studies systematically examining these differences remain scarce.

Method: Anonymized demographic and clinical data were collected during inpatient examinations at the Paracelsus-Elena Klinik Kassel, Germany, between 2009 and 2019. PD was diagnosed using UK Brain Bank Criteria. Depression and REM sleep behavior disorder (RBD) history were derived from medical records. Motor symptoms, fluctuations, dyskinesias, and non-motor symptoms were assessed using the UPDRS; cognition with the MMSE; and olfaction with the 12-item Sniffin’ Stick identification test.

Results: Data from 10,943 consecutive patients (4,435 female, 6,508 male) were analyzed retrospectively. No significant differences were found between women and men in mean age (70.1 vs. 70.4 years), age at PD onset (63.6 vs. 63.4 years), or disease duration (7.2 vs. 7.0 years). Depression was significantly more common in women, while probable RBD, worse cognition, and poorer olfaction were more prevalent in men. Although mean UPDRS-I, II, and III subscores did not differ significantly between sexes, women had significantly higher UPDRS-IV scores (4.25 vs. 3.45), indicating a greater burden of motor complications.

Conclusion: These findings highlight important sex-related differences in a real-world PD cohort, most notably a higher burden of motor complications in women and differences in non-motor symptoms, including depression and RBD. Ongoing analyses incorporating treatment data will help clarify the drivers of these differences. Collectively, these results underscore the need for sex-sensitive approaches in PD management and for clinical trials that adequately include and stratify women, a population historically underrepresented in neurological research.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/sex-specific-differences-in-parkinsons-disease-a-retrospective-analysis-of-over-10000-patients-from-the-paracelsus-elena-hospital-a-specialized-movement-disorder-clinic-in-germany/