title: Gender effect on non-motor symptoms in Parkinson's disease: are men more at risk?
abstract: Several gender differences have been reported in Parkinson's Disease (PD). We evaluated the burden of non-motor symptoms (NMS) in PD and the possible gender differences in their occurrence.
  
  
  
  The FRAGAMP study is a large multicenter case-control study. PD patients and controls underwent a face-to-face interview and a neurological examination performed by trained neurologists. Presence of NMS was investigated using a standardized questionnaire; cognitive impairment and depression were assessed using the Mini Mental State Examination and the Hamilton Depression Rating Scale respectively.
  
  
  
  585 PD patients (59.5% men) and 481 controls (34.9% men) were enrolled in the study. All NMS were significantly more frequent among PD patients than controls. PD women showed a significantly higher frequency of depression and urinary disturbances than parkinsonian men; a close frequency among PD women and men was recorded for hallucination, cognitive impairment and sleep disorders. Nonetheless, with respect to the control population, according to logistic regression stratified by sex and adjusted by age, PD men showed a stronger positive significant association with almost all NMS compared to women, excepting for urinary disturbances. The strongest association among PD men was recorded for cognitive impairment (adjusted OR 5.44 for men and 2.82 for women) and depression (adjusted OR 30.88 for men and 12.72 for women).
  
  
  
  With respect to the general population, presence of NMS was stronger associated with male gender. Our data suggest that the presence of NMS among PD men is more strictly due to the neurodegenerative processes related to PD.
authors.affiliation: Dipartimento G.F. Ingrassia, Sezione di Neuroscienze, Università Degli Studi di Catania, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Nicoletti
authors.affiliation: Dipartimento G.F. Ingrassia, Sezione di Neuroscienze, Università Degli Studi di Catania, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Vasta
authors.affiliation: Dipartimento G.F. Ingrassia, Sezione di Neuroscienze, Università Degli Studi di Catania, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Mostile
authors.affiliation: Istituto di Bioimmagini e Fisiologia Molecolare - Consiglio Nazionale delle Ricerche, Catanzaro, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Nicoletti
authors.affiliation: Clinica Neurologica, Università "Magna Græcia" di Catanzaro, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Arabia
authors.affiliation: Dipartimento di Scienze Mediche di Base, Neuroscienze e Organi di Senso, Università di Bari, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Iliceto
authors.affiliation: Dipartimento di Scienze Mediche di Base, Neuroscienze e Organi di Senso, Università di Bari, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Lamberti
authors.affiliation: Divisione di Neurologia, Ospedale Misericordia, Grosseto, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Marconi
authors.affiliation: Dipartimento di Neuroscienze, Università di Messina, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Morgante
authors.affiliation: Dipartimento di Medicina e Chirurgia, Università degli Studi di Salerno, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Barone
authors.affiliation: Istituto di Bioimmagini e Fisiologia Molecolare - Consiglio Nazionale delle Ricerche, Catanzaro, Italy; Clinica Neurologica, Università "Magna Græcia" di Catanzaro, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Quattrone
authors.affiliation: Dipartimento G.F. Ingrassia, Sezione di Neuroscienze, Università Degli Studi di Catania, Italy. Electronic address: m.zappia@unict.it.
authors.forename: M
authors.initials: M
authors.lastname: Zappia
mesh_terms: D000368:Aged; D016022:Case-Control Studies; D003866:Depressive Disorder; D005260:Female; D005767:Gastrointestinal Diseases / Q000175:diagnosis / Q000503:physiopathology* / Q000523:psychology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000175:diagnosis / Q000503:physiopathology* / Q000523:psychology; D012307:Risk Factors; D012727:Sex Characteristics; D012893:Sleep Wake Disorders / Q000175:diagnosis / Q000503:physiopathology* / Q000523:psychology
keywords: Case-control studies; Gender effect; Non-motor symptoms; Parkinson's disease/Parkinsonism