Objective: To examine gender differences in risk tolerance in Parkinson’s disease and to determine factors associated with risk tolerance.

Background: Deep brain stimulation (DBS) is a widely recognized treatment option for Parkinson’s disease with known gender disparities in utilization that are presumed to be due to risk aversion of women. (1,2). We hypothesize that social roles and social support modify the relationship between gender and risk tolerance.

Method: Participants with Parkinson’s disease were recruited from an academic movement disorders center clinic. The primary outcomes were gender differences in risk tolerance and in relation to deep brain stimulation surgery. Assessments included Willingness to Take Risks survey, Health Risk Attitude Scale, the DBS Risk Attitude Survey, and the Multidimensional Scale of Perceived Social Support. We also collected demographic, clinical data and caregiving status. Data were analyzed using t-tests for risk tolerance evaluation and spearman correlations to evaluate risk in different contexts. Linear regression and mixed effects models were used to assess factors associated with risk tolerance.

Results: A total of 91 participants completed the surveys, 50 men and 41 women. The men (52% 70 years+) were older than the women (39% 70 years+). The majority of the cohort had been diagnosed within 5 years. Higher risk tolerance was associated with male sex for general risk (p=0.013) but not for health-related risk (p=0.5). Women demonstrated more stable risk tolerance compared to men when assessing context specific risk. When considering a hypothetical device, men accepted a significantly higher risk for anxiety compared to women (38% vs 23.6%, p=0.016). There was no difference in acceptable risk for brain bleed with the device. Marital status and caregiving status was not associated with willingness to take risk in health-related risks. For men and women who had high social support, there was a trend towards women being less willing to take risk.

Conclusion: Men demonstrated higher risk tolerance in general and for anxiety when considering a neurostimulation device. Social support was not associated with willingness to take risk. Gender difference in risk tolerance may contribute to, but is unlikely the sole reason for lower utilization of DBS among women.

References: 1.Diamond A, Jankovic J. The effect of deep brain stimulation on quality of life in movement disorders. J Neurol Neurosurg Psychiatry. 2005 Sep;76(9):1188-93. doi: 10.1136/jnnp.2005.065334. PMID: 16107348; PMCID: PMC1739801.
2.Jost ST, Strobel L, Rizos A, Loehrer PA, Ashkan K, Evans J, Rosenkranz F, Barbe MT, Fink GR, Franklin J, Sauerbier A, Nimsky C, Sattari A, Ray Chaudhuri K, Antonini A, Timmermann L, Martinez-Martin P, Silverdale M, Kalbe E, Visser-Vandewalle V, Dafsari HS; EUROPAR and the International Parkinson and Movement Disorders Society Non-Motor Parkinson’s Disease Study Group. Gender gap in deep brain stimulation for Parkinson’s disease. NPJ Parkinsons Dis. 2022 Apr 20;8(1):47. doi: 10.1038/s41531-022-00305-y. PMID: 35444187; PMCID: PMC9021281

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MDS Abstracts - https://www.mdsabstracts.org/abstract/do-differences-in-risk-aversion-and-perceived-social-support-contribute-to-gender-disparities-in-deep-brain-stimulation-utilization-in-parkinsons-disease/