Objective:

To examine sex differences in clinical characteristics and patient-reported outcomes (PRO) in Parkinson disease (PD). 

Background:

Patient-reported outcomes (PRO) provide valuable information about disease perception, however few studies have evaluated sex disparities between PRO and clinical exam ratings.

Design/Methods:

We performed a retrospective analysis utilizing data from two large IRB-approved natural history studies of PD. Independent samples t-test and Mann-Whitney U were used to compare continuous variables, and chi-square and Fisher’s exact test for categorical variables.  

Results:

The study sample consisted of 1590 PD patients from two separate institutions, defined as Cohort 1 (N=433) and Cohort 2 (N=1157), with Male(M)/Female(F) ratios of 1.7. Demographics reported as mean (SD), were similar between sexes, with no significant statistical differences in either cohort. For Cohort 1, Age: (years:) M 65 (8.3), F 64 (9.4), p 0.05, disease duration: M 8.6 (5.4), F 8.8 (5.9), p 0.87. For Cohort 2, Age: M 67.6 (9.9), F 68.3 (9.8), p 0.2, disease duration: M 7.2 (5.7), F 7.9 (6.8), p 0.07. M had a higher motor exam severity score than F. For Cohort 1, MDS-UPDRS Part III: M 27.9 (12.3) vs. F 23.7 (12.2), p <0.001, and for Cohort 2: M 27.7 (12.2) vs. F 23.3 (13.2), p=0.07. However, in both cohorts, PROMIS-29 patient-reported Physical Function was worse in females, Cohort 1: M 47.2 (8.8) vs. F 45.4 (8.8), p=0.020, and Cohort 2: M 44.6 (10.2) vs. F 41.8 (10.0), p=0.0001. Greater anxiety was reported by females in both cohorts, Cohort 1: M 50.2 (9.1), F 52.9 (9.5), p=0.003; Cohort 2: M 50.5(9.5), F 53.5 (9.7), p=0.0001. 

Conclusions:

The divergence between clinician-reported motor scores and patient-reported physical function shows that males perceive better function in the setting of greater disease severity. Greater emotional distress in women may contribute to disparities in perception of function.