Parkinson’s Differs in Gender

If you’ve seen one person with Parkinson’s, you’ve seen one person with Parkinson’s. 

A recent literature review by Italian scientists was published in the Journal of Parkinson’s Disease, July 2019, describing how Parkinson’s disease affects men and women differently.

PD is a slowly progressive disorder that affects movement, muscle control and balance. It is the second most common age-related, neurodegenerative disorder, affecting about 3% of the population by the age of 65 and up to 5% of individuals over 85 years of age.

Male PD Differences and Risk Factors

  • Twice as likely to be diagnosed with PD
  • Slow or rigid movement is dominant symptom when first diagnosed (bradykinesia)
  • More serious postural problems
  • Abnormal severe forward flexion of the trunk when standing or walking (camptocormia))
  • Freezing of gait develops later, when one gets “stuck” in place and temporarily cannot move feet forward
  • Severe drooling
  • Worse general cognitive abilities
  • Executive function deficits (attention and working memory)
  • Mild cognitive impairment (MCI)  and its more rapid progression in the severe stage of the disease (MCI often precedes dementia)
  • Control disorders such as pathological gambling and hypersexuality
  • Low body mass index (<18.5) which is strongly associated with reduced survival time, is significant only in men
  • Reduction of life satisfaction in second half of life

Female PD Differences and Risk Factors

  • Tremor is usually the dominant sign when first diagnosed and is associated with recurrent falls and more severe pain syndromes
  • More apt to develop postural instability
  • Less likely to have specialist care such as neurologist
  • May take higher medication doses due to lower body weight leading to dyskinesia
  • More rapid disease progression with lower survival rate
  • Non-motor symptoms such as fatigue, depression, restless legs, constipation, pain, loss of taste or smell, weight change and excessive sweating are more common and severe
  • Higher predisposition to critical swallowing difficulties (dysphagia)
  • PD with dementia has a greater impact on life expectancy
  • Impaired visuospatial function
  • Perform better on verbal fluency and cognition tests
  • Less likely to have an informal caregiver support from spouse, family or friend
  • More apt to use paid caregiver services

The familiar comment: If you’ve seen one person with Parkinson’s, you’ve seen one person with Parkinson’s still rings true. A male and a female will not experience PD in the same way. Neither will two females or two males!

“It is becoming increasingly evident that PD differs in women and men,” said lead author Fabio Blandini, M.D., scientific director of the IRCCS Mondino Foundation, National Institute of Neurology, Pavia, Italy. “Recent research findings suggest that biological sex also impacts on disease risk factors and, potentially, on molecular mechanisms involved in the pathogenesis of PD.”

Studies in this area are under-represented, both from the clinical and research perspective, especially for females. We are still far away from the actual understanding of what underlies such differences. Only then can we develop tailored interventions that meet distinct requirements of men and women with PD.

If you would like to read the the abstract of this literature survey, it can be found at Journal of Parkinson’s Disease.


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