Sex-specific progression of Parkinson’s disease: A longitudinal mixed-models analysis

<p>BACKGROUND: Despite its relevance, the clinical progression of motor- and non-motor symptoms associated with Parkinson’s disease (PD) is poorly described and understood, particularly in relation to sex-specific differences in clinical progression.OBJECTIVES: Identification of differential aspects in disease progression in men and women with PD.METHODS: Linear mixed-model analyses of a total of 802 people with typical PD from the Luxembourg Parkinson’s study’s prospective cohort, stratified by sex. Marginal effects of disease duration on the outcomes (disease duration averaged over random effects) in analyses stratified by sex were estimated and illustrated for the following outcomes: MDS-UPDRS I-IV, apathy, depression, global cognition, olfaction, bodily discomfort, rapid eye movement sleep behaviour disorder, quality of sleep, dysphagia, patient-reported functional mobility, postural instability and gait disturbances and tremor. Men and women had similar age and median time of follow-up was 3 years.RESULTS: Compared to men, we observed slower disease progression in women for cognition, apathy, quality of sleep and MDS-UPDRS II and significantly worse scores for depression and pain at baseline. Only bodily discomfort and depression (in the first ten years since diagnosis) progressed faster in women. Intensity of tremor decreased over time for both groups.CONCLUSION: Differential progression of symptoms in men and women with PD exists and needs to be explored further. To enhance well-being in PD, we recommend considering a sex-specific approach to managing PD symptoms.</p>