Sex-specific Characteristics of Parkinson’s Disease: Characteristics at Diagnosis and Complications in the Disease Course

Identifying the sex-specific characteristics of Parkinson’s disease (PD) is essential to advance patient care. This study aimed to investigate the baseline characteristics, pharmacotherapy, and associated risk factors between male and female PD patients. A cohort study comprising two annual cohorts (2013 and 2014) of National Health Check-up Data linked to the National Health Insurance Claims Database was implemented. PD patients were ascertained with v-124 beneficiary insurance claim code as the principal diagnosis. Multivariable logistic regression and cox proportional hazard models were implemented. The primary outcome was to compare socio-demographic and disease characteristics at PD diagnosis. Secondary outcomes were to compare new onset complications at 3-year PD diagnosis and Levodopa equivalent daily dose (LEDD) at 1-year PD diagnosis. A total of 5,255 new-onset PD patients were included; male (n=2,439) and female (n=2,816). Both groups had the highest incidence of PD in the 70-79 years group. Female patients received lower LEDD in the first prescription at diagnosis, despite higher BMI in females than in males (p<0.001). At 3 years after PD diagnosis, female patients demonstrated increased depression (1.50 times) and fracture (1.79 times) but decreased constipation (39.6 %) compared to males. Advance age were significant risk factors to develop dementia, constipation and fracture in both sexes. Obesity (32%) decreased and current smoking status (1.65 times) increased fracture risk in males. Depression increased dementia (2.29 times) and constipation (1.66 times) in males whereas psychotic disorders increased dementia in females (3.33 times). Sex-specific health-related characteristics and comorbidities at the time of diagnosis were predictable factors for future complications. Effective management of comorbidities at diagnosis and health-related behaviours by sex difference could enhance the precision care for PD patients.