Sex specific cognitive differences in Parkinson disease

Abstract

Parkinson disease (PD) is a progressive neurodegenerative disorder that is 1.5 times more common in males than in females. While motor progression tends to be more aggressive in males, little is known about sex difference in cognitive progression. We tested the hypothesis that there are sex differences in cognitive dysfunction in non-demented PD. We evaluated 84 participants (38 females) with PD and 59 controls (27 females) for demographic variables and cognitive function, including attention, working memory, executive function, and processing speed. Multivariate ANOVA revealed no significant differences between groups for demographic variables, including age, years of education, global cogntition, daytime sleepiness, predicted premorbid IQ, UPDRS score, PD phenotype, or disease duration. For cognitive variables, we found poorer performance in males versus females with PD for measures of executive function and processing speed, but no difference between male and female controls. Specifically, PD males showed greater deficits in Verbal Fluency (category fluency, category switching, and category switching accuracy), Color Word Interference (inhibition), and speed of processing (SDMT). There were no differences in measures of working memory or attention across sex and inconsistent findings for switching. Our data indicate that males with PD have significantly greater executive and processing speed impairments compared to females despite no differences in demographic variables or other measures of disease severity. Our findings are consistent with the steeper slope of disease progression reported in males with PD.

The Effect of the COVID-19 Pandemic on People with Parkinson’s Disease

“…Women with PD without COVID-19 reported worsening or new onset of PD symptoms more often than men without COVID-19 in all domains except cognition. Other studies have similarly suggested that women with PD report more mood symptoms 31 32 and fewer cognitive problems 33 than men, and our findings may be more reflective of differences in symptoms between men and women with PD rather than reflecting changes due to the pandemic.…”

Differential effects of sex on longitudinal patterns of cognitive decline in Parkinson’s disease

“…However, there have been few previous comprehensive investigations of sex-based differences in individual cognitive domains over time [ 31 ], as in the present study. Some prior studies have been purely cross sectional in nature [ 5 , 9 , 10 , 12 , 17 – 19 ], while longitudinal studies have not examined the sex-specific differences in various cognitive domains [ 20 ], or have not focussed primarily on elucidating the impact of sex on cognition [ 32 ]. Here, our findings suggest that sex is a significant determinant of domain-specific cognitive performance, in agreement with prior literature.…”

“…Although sex associations within PD are well reported, there is a lack of studies investigating sex-specific effects on individual cognitive domains, as well as longitudinal cognitive domain-specific decline in PD. Prior studies examining the effect of sex have been cross sectional in nature [5,9,10,12,[17][18][19], or have not considered the effect in various cognitive domains [20].…”

Sex and onset-age-related features of excessive daytime sleepiness and night-time sleep in patients with Parkinson’s disease

“…However, as the disease progresses, women seem to be at higher risk of treatment-related complications, such as motor and nonmotor fluctuations, dyskinesia, and high levels of disability [ 9 , 10 ]. In terms of NMSs, male patients may experience more cognitive impairment and urinary symptoms, but less emotional, apathy and pain symptoms [ 11 , 12 ]. LOPD also shows more NMSs, such as cognitive dysfunction, autonomic dysfunction, and gastrointestinal symptoms [ 13 , 14 ].…”