title: Diagnosis and referral delay in women with Parkinson's disease.
abstract: BACKGROUND
  Gender differences in Parkinson's disease may be attributable to biological and environmental factors as well as health care-seeking behaviors and diagnosis bias.
  
  
  OBJECTIVE
  The goal of this pilot study was to determine whether there are gender discrepancies in diagnosis and time to present to a movement disorder specialist, and to assess whether clinical and referral factors account for these differences.
  
  
  METHODS
  We report data on diagnosis, health care-seeking patterns, and clinical features in men and women with early Parkinson's disease treated at a tertiary care center.
  
  
  RESULTS
  A total of 109 patients with Parkinson's disease (53 women and 56 men; median age at onset, 60.3 years) were included in this study. Although men and women did not differ in time from symptom onset to first physician visit, duration from symptom onset to movement disorder specialist visit was longer in women than in men. The expected duration from onset to movement disorder specialist visit for women was 61% greater than for men in the unadjusted model (P = 0.002).
  
  
  CONCLUSIONS
  There were gender differences in time to present to a movement disorder specialist in these patients with early Parkinson's disease, and further study in larger samples is warranted.
authors.affiliation: Department of Neurology, Beth Israel Medical Center, New York, New York 10003, USA. Rsaunder@bethisraelny.org
authors.forename: Rachel
authors.initials: R
authors.lastname: Saunders-Pullman
authors.forename: Cuiling
authors.initials: C
authors.lastname: Wang
authors.forename: Kaili
authors.initials: K
authors.lastname: Stanley
authors.forename: Susan B
authors.initials: SB
authors.lastname: Bressman
mesh_terms: D000368:Aged; D057210:Delayed Diagnosis; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination / Q000706:statistics & numerical data; D010300:Parkinson Disease / Q000175:diagnosis* / Q000453:epidemiology; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D010865:Pilot Projects; D011369:Professional-Patient Relations; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D017678:Sex Distribution; D016387:Women's Health