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

[en] BackgroundDespite 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.ObjectiveIdentification of differential aspects in disease progression in men and women with PD.MethodsLinear mixed-model analyses of 802 people with typical PD from the Luxembourg Parkinson's study's prospective cohort (median time of follow-up = three years). We estimated the effect of time and its moderation by sex (alpha ≤ 0.05), including confidence intervals, for the following outcomes: MDS-UPDRS I-IV, Starkstein Apathy Scale, Beck Depression Inventory, Montreal Cognitive Assessment (MoCA), Sniffin' sticks, bodily discomfort, rapid eye movement sleep behavior disorder questionnaire, PD Sleep Scale (PDSS), Munich Dysphagia Test-PD, Functional Mobility Composite Score, and the MDS-based tremor and postural instability and gait disturbances scale. In addition, the marginal means illustrated the symptoms' trajectories in men and women. Men and women had similar age.ResultsOverall, we observed a slower progression (interaction effect) in women compared to men, especially for MoCA (-0.159, 95%CI [-0.272, -0.046], p = 0.006), PDSS (-0.716, 95%CI [-1.229, -0.203], p = 0.006), PIGD (0.133, 95%CI [0.025 0.241], p = 0.016), and MDS-UPDRS II (0.346, 95%CI [0.120, 0.572], p = 0.003). The finding for MDS-UPDRS II was significant (FWER of 5%) after adjustment for multiple comparisons (Bonferroni-Holm).ConclusionsNext to the further exploration of sex-specific progression, interventions, proactive monitoring and communication strategies tailored to the symptoms progression and needs of men and women need to be developed.
[en] Although Parkinson's disease is 1.4 times more frequent in men compared to women, it is not clear how the symptoms develop over time in men and women. Consequently, we aimed to describe the changes of different symptoms over time in both sexes and to find out if women with Parkinson's disease showed a different progression than men. By analyzing repeated measurements of 802 individuals, we found an overall slower worsening of the symptoms in women compared to men, particularly for memory, sleep, walking and balance as well as motor symptoms in general. Consequently, compared to women, men not only experience Parkinson's disease more frequently but also experience a faster worsening of symptoms. More research is needed to fully understand why. To improve the well-being of men and women with Parkinson's disease, we suggest taking into account the important differences between them when doing research and providing health care.

Disciplines :

Neurology

Author, co-author :

HANFF, Anne-Marie ; University of Luxembourg > Faculty of Science, Technology and Medicine (FSTM) > Department of Health, Medicine and Life Sciences (DHML) > Medical Education ; Transversal Translational Medicine, Luxembourg Institute of Health, Strassen, Luxembourg ; Department of Epidemiology, CAPHRI Care and Public Health Research Institute, Maastricht University Medical Centre+, Maastricht, The Netherlands ; Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, The Netherlands

McCrum, Christopher ; Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, The Netherlands

RAUSCHENBERGER, Armin ; University of Luxembourg > Luxembourg Centre for Systems Biomedicine > Biomedical Data Science > Team Enrico GLAAB ; Bioinformatics and Artificial Intelligence, Department of Medical Informatics, Luxembourg Institute of Health, Strassen, Luxembourg

Aguayo, Gloria A ; Department of Precision Health, Luxembourg Institute of Health, Strassen, Luxembourg

PAULY, Claire ; University of Luxembourg > Luxembourg Centre for Systems Biomedicine > Translational Neuroscience > Team Rejko KRÜGER ; Transversal Translational Medicine, Luxembourg Institute of Health, Strassen, Luxembourg ; Parkinson Research Clinic, Centre Hospitalier de Luxembourg, Luxembourg, Luxembourg

JONSDOTTIR, Sonja ; University of Luxembourg ; Transversal Translational Medicine, Luxembourg Institute of Health, Strassen, Luxembourg ; Parkinson Research Clinic, Centre Hospitalier de Luxembourg, Luxembourg, Luxembourg

TSURKALENKO, Olena ; University of Luxembourg ; Transversal Translational Medicine, Luxembourg Institute of Health, Strassen, Luxembourg ; Parkinson Research Clinic, Centre Hospitalier de Luxembourg, Luxembourg, Luxembourg ; Digital Medicine group, Luxembourg Institute of Health, Strassen, Luxembourg

Zeegers, Maurice P ^✱; Department of Epidemiology, Care and Public Health Research Institute, School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, the Netherlands

LEIST, Anja ^✱; University of Luxembourg

Krüger, Rejko ^✱; Transversal Translational Medicine, Luxembourg Institute of Health, Strassen, Luxembourg ; Translational Neurosciences, Luxembourg Centre for Systems Biomedicine, University of Luxembourg, Esch-sur-Alzette, Luxembourg ; Parkinson Research Clinic, Centre Hospitalier de Luxembourg, Luxembourg, Luxembourg

NCER-PD consortium

^✱ These authors have contributed equally to this work.

External co-authors :

yes

Language :

English

Title :

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

Publication date :

19 May 2025

Journal title :

Journal of Parkinson's Disease

ISSN :

1877-7171

eISSN :

1877-718X

Publisher :

SAGE Publications, United States

Pages :

1877718X251339201

Peer reviewed :

Peer Reviewed verified by ORBi

Additional URL :

https://journals.sagepub.com/doi/pdf/10.1177/1877718X251339201

Funders :

Fonds National de la Recherche Luxembourg
Fonds National de la Recherche Luxembourg

Available on ORBilu :

since 07 January 2026

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