Parkinson’s disease (PD) 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 the people over 85 years. While it affects both men and women, emerging research reveals that gender plays a significant role in PD’s epidemiology, clinical presentation, and management. Overlooking the specific needs of women diagnosed with Parkinson’s makes women less likely to receive proper treatment or informal support
This blog explores the intricate web of gender disparities in PD, shedding light on how understanding these differences can lead to more accurate diagnoses and tailored treatment plans.
Epidemiological Gender Disparities
PD does not discriminate based on gender, but it does exhibit a distinct pattern in its prevalence. Studies have consistently shown that men are twice as likely to develop PD as women. However, this is only part of the story. Surprisingly, women with PD have a higher mortality rate and experience a faster progression of the disease. This stark difference in outcomes emphasizes the need for gender-sensitive approaches to managing PD
Motor and Nonmotor Symptoms
PD's impact on motor and nonmotor symptoms differs between men and women. For instance, women tend to develop motor symptoms later, and they exhibit specific characteristics like reduced rigidity and tremor as more common initial symptoms. Men, on the other hand, face their own set of challenges, including a higher propensity for freezing gait. Additionally, male PD patients are more likely to develop the disabling motor complication known as camptocormia, whereas female sex is one of the factors in predictors of progression to falling in PD
Non-motor symptoms also vary by gender. Women experience more severe and common symptoms such as fatigue, depression, restless legs, constipation, pain, loss of taste or smell, weight changes, and excessive sweating.
The relationship between the female sex and pain has been recently confirmed in a large clinical study demonstrating that, together with affective and autonomic symptoms, motor complications, and younger age, the female sex predicts overall pain severity
Cognitive Differences
Cognitive impairment is a common complication of PD, and gender influences how it manifests. Studies have shown that male PD patients generally have worse cognitive abilities and are more prone to mild cognitive impairment. Conversely, female PD patients perform better in certain cognitive domains but may struggle with visuospatial function (walking through doorways without bumping into the door frames, driving, or crossing the road - judging vehicle distance and speed accurately). Recognizing these cognitive differences is crucial for providing targeted interventions.
Psychological and Emotional Well-being
PD's impact on psychological and emotional well-being also differs by gender. Women with PD often experience more severe and persistent anxiety and depression, while men are more prone to impulse control disorders like pathological gambling and hypersexuality. Tailoring psychological support and counseling to address these gender-specific issues can improve patients' overall quality of life.
Quality of Life and Daily Functioning
Gender plays a role in how PD affects patients' quality of life and daily functioning. Health-related quality of life (HrQoL) assessments reveal that the female gender negatively affects physical functioning and socioemotional well-being, while the male gender primarily affects cognition.
Environmental and Lifestyle Factors:
Occupational stress and environmental exposures can impact PD risk. Recent research has shown that high job demands increase PD risk in men, especially those with higher education. In contrast, high job control raises the risk more significantly in less-educated women. Occupational exposure to neurotoxic substances like pesticides and solvents also affects PD incidence.
A recent nationwide study conducted in France, based on a comprehensive analysis of industry sectors, showed a significant association between PD incidence and specific sectors (e.g., agriculture, metallurgy, textile).
Additionally, physical activity levels play a role, with higher exercise levels in midlife associated with a lower risk of PD, particularly in men.
A large international multicenter cohort study on early PD patients showed that higher self-reported activity scores were associated with younger age and male gender. Older patients, especially women, may be particularly vulnerable to inactivity and its complications
Furthermore, Park and colleagues demonstrated that a low body mass index (<18.5) is strongly associated with reduced survival time, but this reduction is significant only in males.
Conclusion:
The gender differences in Parkinson's disease are a complex web of epidemiological, clinical, and psychosocial factors. Recognizing and understanding these disparities is essential for healthcare professionals to provide more accurate diagnoses and tailored treatment plans. By taking gender-specific symptoms and risk factors into account, we can improve the quality of life for individuals living with PD and enhance our ability to manage this challenging neurodegenerative disease.
As always, stay informed, be proactive, and never hesitate to reach out for help when needed.
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