PD Worsens QOL, Increases Depression in Men More Than Women in the Southeast

Males with Parkinson disease (PD) living in the southeastern part of the United States have worse quality of life compared with females with the disease, according to a recent study.

The southeastern areas of the country have worse health outcomes and health-related quality of life (HRQOL) compared with other parts of the United States, the researchers noted, with high rates of diabetes, obesity, cancer, and cardiovascular disease.

It is already known that PD affects both men and women differently, although findings vary across studies. Looking at the functionality of individuals with PD from this region to see if gender possibly plays a part is important to developing personalized treatments for the neurological disease, the researchers wrote in PLoS One.

The retrospective, cross-sectional study study, run by Emory University and the Parkinson Foundation, recruited patients with mild-moderate (Hoehn &Yahr [H&Y] stages I-III, median = 2) idiopathic PD.

Of the 199 participants, 127 were men and 72 were women. Median (SD) age was 69.08 (8.94). Most of the participants were White (155) and 30 were Black; 13 were classified as neither. Overall body mass index (BMI) was 26.40 (4.83), with women having higher BMI than men.

Researchers conducted motor, motor-cognitive, cognitive, and psychosocial tests, questionnaires, and assessments, including:

• Composite Physical Function
• Physical Activity Scale for the Elderly
• Montreal Cognitive Assessment
• MDS-UPDRS parts I-IV
• Parkinson’s Disease Questionnaire 39 (PDQ-39)
• Fullerton Advanced Balance
• The Body Position Spatial Task
• Beck Depression Inventory-II
• Timed Up and Go
• The Delis-Kaplan Executive Function System Color Word Interference Test

Multiple regression analyses adjusted for age and housing type. The results of analysis illustrated that the impact of gender appeared the most in PD-specific measures of motor symptoms, QOL and activities of daily living (ADL).

In the PDQ-39, for example, men showed worse scores for the PDQ-39 subscales of mobility (P < .05; adjusted for age and housing); ADL (P < .001; univariate and adjusted models); emotional well-being (P < .05; adjusted for age as well as age and housing); as well as in communication and for cognitive impairment.

Across the board, men also displayed more depressive symptoms

Women performed worse when asked to perform serial 3 subtractions and had had slower fast gait speed compared with men.

“It is possible that the PD-specific measures are more attuned to issues that most affect men from this region, as opposed to the women,” wrote the authors, trying to explain the results.

The study had a few limitations. More men than women participated, although the authors noted that women are undiagnosed with PD, lack the support of a caregiver more often than men, and may have other reasons that would make participation difficult. In addition, neuropsychological assessments did not measure language or memory, which would be essential for future research about gender differences.

Reference

Abraham A, Bay AA, Ni L, et al. Gender differences in motor and non-motor symptoms in individuals with mild-moderate Parkinson’s disease. PloS One. Published online January 11, 2023. doi:10.1371/journal.pone.0272952