Background/Aims: Gender differences of health-related quality of life (HRQoL) in patients with various disorders have been reported. Various nonmotor symptoms (NMSs) also affect the patients' lives and HRQoL, even in the early stages of Parkinson disease (PD). Our study aimed to identify whether there are gender differences of HRQoL in PD patients in the early stages, and which NMSs are associated with HRQoL depending on gender. Method: Eighty-nine PD patients (47 males, 42 females) and 36 healthy controls were enrolled. We evaluated HRQoL, NMSs, and their associations in each gender. Result: The total Parkinson Disease Quality of Life Questionnaire and Beck Anxiety Inventory scores were higher in female patients than in male patients. The correlation analysis revealed no association between NMSs and HRQoL in male patients. In female patients, HRQoL was highly correlated with depression, and moderately associated with fatigue. Conclusions: Gender differences of an association between HRQoL and NMSs exist in PD. We found that fatigue and depression were the main determinants of poor HRQoL in female patients even in the early stages. We suggest that a gender-specific therapeutic approach is important, and it is necessary to pay special attention to the predictors associated with causing poor HRQoL.

Keywords:
Parkinson disease, Quality of life, Nonmotor symptoms, Sex differences, Fatigue, Depression
1.
Martínez-Martín P, Payo BF: Quality of life in Parkinson's disease: validation study of the PDQ-39 Spanish version. J Neurol 1998;245:S34-S38.
2.
De Lau LM, Breteler MM: Epidemiology of Parkinson's disease. Lancet Neurol 2006;5:525-535.
3.
Martinez-Martin P, Rodriguez-Blazquez C, Kurtis MM, Chaudhuri K: The impact of non-motor symptoms on health-related quality of life of patients with Parkinson's disease. Mov Disord 2011;26:399-406.
4.
Karlsen KH, Larsen JP, Tandberg E, Mæland JG: Influence of clinical and demographic variables on quality of life in patients with Parkinson's disease. J Neurol Neurosurg Psychiatry 1999;66:431-435.
5.
Chaudhuri KR, Healy DG, Schapira AH: Non-motor symptoms of Parkinson's disease: diagnosis and management. Lancet Neurol 2006;5:235-245.
6.
Müller B, Assmus J, Herlofson K, Larsen JP, Tysnes O-B: Importance of motor vs non-motor symptoms for health-related quality of life in early Parkinson's disease. Parkinsonism Relat Disord 2013;19:1027-1032.
7.
Pettersen KI, Reikvam A, Rollag A, Stavem K: Understanding sex differences in health-related quality of life following myocardial infarction. Int J Cardiol 2008;130:449-456.
8.
Hsu H-C: Gender differences in health-related quality of life among the elderly in Taiwan. Asian J Heal Inf Sci 2007;1:366-376.
9.
Kirchengast S, Haslinger B: Gender differences in health-related quality of life among healthy aged and old-aged Austrians: cross-sectional analysis. Gend Med 2008;5:270-278.
10.
Kim JS, Lee K-B, Roh H, Ahn M-Y, Hwang H-W: Gender differences in the functional recovery after acute stroke. J Clin Neurol 2010;6:183-188.
11.
Bushnell CD, Reeves MJ, Zhao X, Pan W, Prvu-Bettger J, Zimmer L, Olson D, Peterson E: Sex differences in quality of life after ischemic stroke. Neurology 2014;82:922-931.
12.
Hughes AJ, Daniel SE, Kilford L, Lees AJ: Accuracy of clinical diagnosis of idiopathic Parkinson's disease: a clinico-pathological study of 100 cases. J Neurol Neurosurg Psychiatry 1992;55:181-184.
13.
Pavon JM, Whitson HE, Okun MS: Parkinson's disease in women: a call for improved clinical studies and for comparative effectiveness research. Maturitas 2010;65:352-358.
14.
Lubomski M, Louise Rushworth R, Lee W, Bertram KL, Williams DR: Sex differences in Parkinson's disease. J Clin Neurosci 2014;21:1503-1506.
15.
Martinez-Martin P, Falup Pecurariu C, Odin P, van Hilten JJ, Antonini A, Rojo-Abuin JM, Borges V, Trenkwalder C, Aarsland D, Brooks DJ, Ray Chaudhuri K: Gender-related differences in the burden of non-motor symptoms in Parkinson's disease. J Neurol 2012;259:1639-1647.
16.
Szatmari S, Illigens BM, Siepmann T, Pinter A, Takats A, Bereczki D: Neuropsychiatric symptoms in untreated Parkinson's disease. Neuropsychiatr Dis Treat 2017;13:815-826.
17.
Shulman LM: Gender differences in Parkinson's disease. Gend Med 2007;4:8-18.
18.
Thanvi B, Munshi S, Vijaykumar N, Lo T: Neuropsychiatric non-motor aspects of Parkinson's disease. Postgrad Med J 2003;79:561-565.
19.
Schrag A, Jahanshahi M, Quinn N: What contributes to quality of life in patients with Parkinson's disease? J Neurol Neurosurg Psychiatry 2000;69:308-312.
20.
Khan N, Kausar R, Khalid A, Farooq A: Gender differences among discrimination & stigma experienced by depressive patients in Pakistan. Pak J Med Sci 2015;31:1432-1436.
21.
Lou J-S, Kearns G, Oken B, Sexton G, Nutt J: Exacerbated physical fatigue and mental fatigue in Parkinson's disease. Mov Disord 2001;16:190-196.
22.
Brown RG, Dittner A, Findley L, Wessely SC: The Parkinson Fatigue Scale. Parkinsonism Relat Disord 2005;11:49-55.
23.
Elbers RG, van Wegen EE, Verhoef J, Kwakkel G: Impact of fatigue on health-related quality of life in patients with Parkinson's disease: a prospective study. Clin Rehabil 2014;28:300-311.
24.
Havlikova E, Rosenberger J, Nagyova I, Middel B, Dubayova T, Gdovinova Z, van Dijk JP, Groothoff JW: Impact of fatigue on quality of life in patients with Parkinson's disease. Eur J Neurol 2008;15:475-480.
25.
Miwa H, Miwa T: Fatigue in patients with Parkinson's disease: impact on quality of life. Intern Med 2011;50:1553-1558.
© 2017 S. Karger AG, Basel
2017
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.