Objective: To investigate the sex differences for disease progression in Parkinson’s disease (PD).

Background: Prevalence and symptom profile in PD differ between women and men. Nevertheless, data regarding sex effects on progression are scarce and inconsistent. Although some reports show no differences by sex, others show faster decline in men regarding cognition, motor symptoms, disability, and daily living activities. Known factors associated with faster progression, which include onset age, depression, and motor profile (postural instability/gait difficulty), need to be better evaluated regarding sex differences. Knowledge of the etiology behind sex differences in PD could lead to new disease-modifying treatment options.

Method: Data were obtained from the STEADY-PD III (NCT02168842), which enrolled 106 women and 230 men within 3 years of PD diagnosis (see Biglan et al., 2017 for study design). Baseline data included demographics, risk factors (cardiovascular disease history, psychiatric disease history, family history, exposure to toxic chemicals, exposure to smoke), PD characteristics at diagnosis and clinical measures (Unified Parkinson’s Disease Rating Scale [UPDRS], Parkinson’s Disease Questionnaire [PDQ-39], Montreal Cognitive Assessment [MoCA], Beck Depression Inventory [BDI]). Women and men were compared using t-tests, chi-square tests, or Fisher’s exact tests. Women and men were also compared on change from baseline to 3 years, using analysis of covariance, adjusting for baseline disease severity scores and baseline demographic and risk measures differing by sex.

Results: At study baseline, men were significantly more educated, with less psychiatric disease history, and a significantly higher percentage of men were married. Men had lower (better) PDQ-39 scores than women. Other demographics, risk factors, PD characteristics at diagnosis and clinical measures were similar.

[table1]

When adjusted for marital status, education, and psychiatric disease history, UPDRS total and sub-scores worsened more in men than women over the 3-year period, as did the MoCA. Changes in PDQ-39 and BDI did not differ by sex.

[table2]

Conclusion: At diagnosis, there was no sex dependent difference in PD characteristics. However, over the course of 3 years, disease progression was faster in men, with more motor impairment, impairment in daily life activities, and cognitive decline. The biological underpinnings of sex dependent difference in PD progression remain to be elucidated.

References: This abstract is submitted on behalf of the STEADY-PD III Investigators.

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