APD  Vol.4 No.4 , November 2015
Exploring Gender-Associated Socioeconomic Differences in Parkinson’s Disease
ABSTRACT
Background: Research on gender in Parkinson’s disease (PD) frequently focuses on clinical differences between men and women. Socioeconomic factors such as race, ethnicity, insurance type, and level of educational attainment, have not been extensively examined in relation to gender differences in PD. The goal of this study was to identify differences in PD presentation in men and women, and identify socioeconomic factors that may confound such differences. Methods: A movement disorder patient database containing 445 patients with idiopathic PD was analyzed for gender differences in motor symptoms and disease complications using linear or logistic regression. Socioeconomic variables were then evaluated as possible confounders. Results: A greater proportion of women were non-white (p < 0.05). Univariate analysis of gender, and multivariate analysis controlling for age at diagnosis and socioeconomic factors were concordant in demonstrating increased frequency of motor fluctuations and dyskinesia in women (p < 0.05). Controlled, multivariate analysis, when compared to univariate analysis, uniquely demonstrated that women were less likely to experience dementia and autonomic dysfunction, relative to men (p < 0.05). Conclusion: Women with PD are susceptible to motor fluctuations and dyskinesia, but may be relatively protected against dementia and autonomic dysfunction. Women and men with PD in our population had different socioeconomic profiles, which may have confounded some gender-associated differences.

Cite this paper
McInnis, R. , Cavanaugh, W. , Weinberg, J. , Saint-Hilaire, M. , Ellias, S. , Frank, S. and Hohler, A. (2015) Exploring Gender-Associated Socioeconomic Differences in Parkinson’s Disease. Advances in Parkinson's Disease, 4, 84-89. doi: 10.4236/apd.2015.44010.
References
[1]   Accolla, E., Caputo, E., Cogiamanian, F., et al. (2007) Gender Differences in Patients with Parkinson’s Disease Treated with Subthalamic Deep Brain Stimulation. Movement Disorders, 22, 1150-1156.
http://dx.doi.org/10.1002/mds.21520

[2]   Caslake, R., Taylor, K., Scott, N., et al. (2013). Age-, Gender-, and Socioeconomic Status-Specific Incidence of Parkinson’s Disease and Parkinsonism in Northeast Scotland: The PINE Study. Parkinsonism & Related Disorders, 19, 515-521. http://dx.doi.org/10.1016/j.parkreldis.2013.01.014

[3]   De Lau, L.M.L., Giesbergen, P.C.L.M., de Rijk, M.C., et al. (2004) Incidence of Parkinsonism and Parkinson Disease in a General Population: the Rotterdam Study. Neurology, 63, 1240-1244.
http://dx.doi.org/10.1212/01.WNL.0000140706.52798.BE

[4]   Van Den Eeden, S.K., Tanner, C.M., Bernstein, A.L., et al. (2003) Incidence of Parkinson’s Disease: Variation by Age, Gender, and Race/Ethnicity. American Journal of Epidemiology, 157, 1015-1022. http://dx.doi.org/10.1093/aje/kwg068

[5]   Taylor, K.S.M., Cook, J.A. and Counsell, C.E. (2007) Heterogeneity in Male to Female Risk for Parkinson’s Disease. Journal of Neurology, Neurosurgery, and Psychiatry, 78, 905-906.
http://dx.doi.org/10.1136/jnnp.2006.104695

[6]   Alves, G., Müller, B., Herlofson, K., et al. (2009) Incidence of Parkinson’s Disease in Norway: The Norwegian Park West Study. Journal of Neurology, Neurosurgery, and Psychiatry, 80, 851-857.
http://dx.doi.org/10.1136/jnnp.2008.168211

[7]   Haaxma, C.A., Bloem, B.R., Borm, G.F., et al. (2007) Gender Differences in Parkinson’s Disease. Journal of Neurology, Neurosurgery, and Psychiatry, 78, 819-824.
http://dx.doi.org/10.1136/jnnp.2006.103788

[8]   Picillo, M., Amboni, M., Erro, R., et al. (2013) Gender Differences in Non-Motor Symptoms in Early, Drug Naïve Parkinson’s Disease. Journal of Neurology, 260, 2849-2855.
http://dx.doi.org/10.1007/s00415-013-7085-x

[9]   Baba, Y., Putzke, J.D., Whaley, N.R., et al. (2005) Gender and the Parkinson’s Disease Phenotype. Journal of Neurology, 252, 1201-1205. http://dx.doi.org/10.1007/s00415-005-0835-7

[10]   Solla, P., Cannas, A., Ibba, F.C., et al. (2012) Gender Differences in Motor and Non-Motor Symptoms among Sardinian Patients with Parkinson’s Disease. Journal of the Neurological Sciences, 323, 33-39.
http://dx.doi.org/10.1016/j.jns.2012.07.026

[11]   Martinez-Martin, P., Pecurariu, C.F., Odin, P., van Hilten, J.J., Antonini, A., Rojo-Abuin, J.M., et al. (2012) Gender-Related Differences in the Burden of Non-Motor Symptoms in Parkinson’s Disease. Journal of Neurology, 259, 1639-1647. http://dx.doi.org/10.1007/s00415-011-6392-3

[12]   Lubomski, M., Rushworth, L.R., Lee, W., Bertram, K.L. and Williams, D.R. (2014) Sex Differences in Parkinson’s Disease. Journal of Clinical Neuroscience, 21, 10-13.
http://dx.doi.org/10.1016/j.jocn.2013.12.016

[13]   Arabia, G., Zappia, M., Bosco, D., Crescibene, L., Bagalà, A., Bastone, L., et al. (2002) Body Weight, Levodopa Pharmacokinetics and Dyskinesia in Parkinson’s Disease. Neurological Sciences, 23, S53-S54.
http://dx.doi.org/10.1007/s100720200066

[14]   Hariz, G.-M., Lindberg, M., Hariz, M.I. and Bergenheim, T.A. (2003) Gender Differences in Disability and Health- Related Quality of Life in Patients with Parkinson’s Disease Treated with Stereotactic Surgery. Acta Neurologica Scandinavica, 108, 28-37.
http://dx.doi.org/10.1034/j.1600-0404.2003.00092.x

[15]   Perez-Lloret, S., Nègre-Pagès, L., Ojero-Senard, A., Damier, P., Destée, A., Tison, F., et al. (2012) Oro-Buccal Symptoms (Dysphagia, Dysarthria, and Sialorrhea) in Patients with Parkinson’s Disease: Preliminary Analysis from the French COPARK Cohort. European Journal of Neurology, 19, 28-37.
http://dx.doi.org/10.1111/j.1468-1331.2011.03402.x

[16]   Riedel, O., Klotsche, J., Spottke, A., Deuschl, G., Förstl, H., Henn, F., et al. (2008) Cognitive Impairment in 873 Patients with Idiopathic Parkinson’s Disease. Results from the German Study on Epidemiology of Parkinson’s Disease with Dementia (GEPAD). Journal of Neurology, 255, 255-264.
http://dx.doi.org/10.1007/s00415-008-0720-2

[17]   Solimeo, S. (2008) Sex and Gender in Older Adults’ Experience of Parkinson’s Disease. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 63, S42-S48.
http://dx.doi.org/10.1093/geronb/63.1.s42

[18]   Hoehn, M. and Yahr, M.D. (1967) Parkinsonism: Onset, Progression and Mortality. Neurology, 17, 427-442. http://dx.doi.org/10.1212/WNL.17.5.427

[19]   Armstrong, M.J., Gruber-Baldini, A.L., Reich, S.G., Fishman, P.S., Lachner, C., Shulman, L.M. (2014) Which Features of PD Predict Earlier Exit from the Workforce? Parkinsonism and Related Disorders, 20, 1257-1259. http://dx.doi.org/10.1016/j.parkreldis.2014.08.005

[20]   Hughes, T.A., Ross, H.F., Musa, S., Bhattacherjee, S., Nathan, R.N., Mindham, R.H.S. and Spokes, E.G.S. (2000) A 10-Year Study of the Incidence of and Factors Predicting Dementia in Parkinson’s Disease. Neurology, 54, 1596-1603. http://dx.doi.org/10.1212/WNL.54.8.1596

[21]   Breteler, M., de Groot, R., Romunde, L. and Hofman, A. (1995) Risk of Dementia in Patients with Parkinson’s Disease, Epilepsy, and Severe Head Trauma: A Register-Based Follow-Up Study. American Journal of Epidemiology, 142, 1300-1305.

[22]   Aarsland, D., Andersen, K., Larsen, J.P., Lolk, A., Nielsen, H. and Kragh-Sørensen, P. (2001) Risk of Dementia in Parkinson’s Disease. Neurology, 56, 730-736. http://dx.doi.org/10.1212/WNL.56.6.730

[23]   Mayeux, R., Denaro, J., Hemenegildo, N., Marder, K., Tang, M.-X., Cote, L.J. and Stern, Y. (1992) A Population- Based Investigation of Parkinson’s Disease with and without Dementia. Archives of Neurology, 49, 492-497. http://dx.doi.org/10.1001/archneur.1992.00530290076015

 
 
Top