Work

Multivariate analysis of sex differences in Parkinson’s disease: the distinct contributions of fall-related self-efficacy and voice handicap

Year: 2026

Type: article

Abstract: BACKGROUND: Sex-related differences in Parkinson's disease (PD) have been frequently reported, yet most studies are descriptive and do not account for confounders. Identifying independent predictors may clarify sex-linked features and guide management. OBJECTIVES: To determine independent predictors of sex differences in a well-characterized PD cohort through multivariate analysis encompassing motor and non-motor domains. METHODS: A total of 652 PD patients (253 women, 392 men) from a tertiary movement disorders clinic were retrospectively evaluated. Assessments included MDS-UPDRS Parts I - IV, Non-Motor Symptoms Scale (NMSS), Hamilton Anxiety and Depression scales, FES-I, Parkinson's Disease Questionnaire-39, and Voice Handicap Index (VHI). Sex differences were analyzed with univariate tests and multivariate logistic regression. RESULTS: Women had higher MDS-UPDRS Part I, anxiety, and FES-I scores, while men scored higher on VHI and NMSS domains. In multivariate models, higher FES-I independently predicted female sex (OR 0.52), and higher VHI predicted male sex (OR 1.83). No independent differences were found for depression, quality of life, motor subtype, levodopa response, or RBD. CONCLUSIONS: Sex differences in PD appear selective rather than global. Fear of falling in women and voice-related disability in men were independently associated with sex in this cohort and should be interpreted descriptively rather than causally.

Source: Neurodegenerative Disease Management

DOI: 10.1080/17582024.2026.2645615