Gender differences in disability and health-related quality of life in patients with Parkinson's disease treated with stereotactic surgery.
OBJECTIVE
To investigate eventual differences between women and men with Parkinson's disease (PD) before and after surgery, with respect to clinical status, disability and health-related quality of life (HRQoL).


METHODS
Twenty-four men and 14 women with PD received a total of 46 surgical procedures (pallidotomy, thalamotomy and deep brain stimulation of the thalamus, pallidum or subthalamic nucleus). The impact of PD on disability and other aspects of HRQoL was analysed separately in men and women before and at a mean of 11 months after surgery, using the following assessment tools: The Unified Parkinson's Disease Rating Scale (UPDRS), the ADL Taxonomy, the Nottingham Health Profile, the Life Satisfaction Questionnaire and a Visual Analogue Scale.


RESULTS
At surgery, women had a significantly longer duration of disease than men (mean: 15 vs. 10 years, P < 0.01). They had a higher stage on the Hoehn and Yahr scale and worse scores on UPDRS parts II (ADL) and IV (complications), as well as on the Schwab and England scale and on the ADL Taxonomy. Following surgery, both men and women showed improvement, but women experienced greater benefit than men in ADL, in emotions, and in social life.


CONCLUSIONS
Perhaps women with PD should be offered surgery more often and earlier in the course of their disease.
Hariz
Gun-Marie
GM
Department of Clinical Neuroscience, Section of Neurosurgery, University Hospital of Northern Sweden, Umeå, Sweden. gun-marie.hariz@neuro.umu.se
Lindberg
Margareta
M
Hariz
Marwan I
MI
Bergenheim
A Tommy
AT
D000368:Aged; D000369:Aged, 80 and over; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010300:Parkinson Disease / Q000601:surgery*; D011184:Postoperative Period; D011446:Prospective Studies; D011788:Quality of Life; D012720:Severity of Illness Index; D012737:Sex Factors; D013238:Stereotaxic Techniques