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

AbstractBACKGROUND: 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 indiseaseprogression in men and womenwith PD.METHODS: Linear mixed-model analysesof a total of 802 peoplewith typical PD from the Luxembourg Parkinson’s study’sprospective cohort,stratified by sex. Marginal effects of disease duration on the outcomes (disease duration averaged over randomeffects)in analysesstratified by sex wereestimated 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 womenhad similar age and mediantime of follow-up was 3years.RESULTS: Compared to men, we observed slower disease progression in women for cognition, apathy, quality of sleep and MDS-UPDRS II andsignificantly worsescoresfor 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.
4CONCLUSION: Differential progression of symptoms in men and womenwith PD exists and needsto be explored further. To enhance well-being in PD, we recommend considering a sex-specificapproach to managing PD symptoms.