Sex differences have been reported in Parkinson’s disease, notably with respect to a lower incidence and less severe motor symptoms in females.

For example, in the Oxford PD Disease Center discovery cohort study, males demonstrated a pattern of more symmetrical and severe symptoms in the upper body whereas postural problems were more evident in women (Szewczyk et al. Parkinsonism Relat Disord 2014;20:99-105). Non-motor symptoms of cognitive impairment, REM behaviour disorder, orthostatic hypotension and sexual dysfunction, were more common in men.

A separate review has examined the impact of gender on cognitive function and emotions (Heller et al. Aging Dis 2013;5:63-75; free full text at www.ncbi.nlm.nih.gov/pmc/articles/PMC3901615/pdf/ad-5-1-63.pdf). Overall, cognitive dysfunction appeared to be more common in males, although the authors noted that test results are inconsistent. Males with PD were less accurate than females in identifying fearful expression, which is the opposite of what is found in healthy subjects. Women generally reported poorer quality of life and greater disability than men.