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Estimates of the 2019 “Strategic Brain Health Report” say that in Poland, about 100 people suffer from Parkinson’s disease. people. Kalisz or Legnica have approximately that number of inhabitants. The disease is inevitably associated with the loss of productivity not only of patients, but also of their caregivers, which costs on average more than twice as much annually as the expenses of the Social Insurance Institution (ZUS) for the payment of benefits due to the inability to work of diagnosed people (PLN 113 million in 2016). Interestingly, this disease acts selectively, clearly attacking men more often. Prof. Wojciech Kozubski, MD, PhD, head of the Department and Clinic of Neurology at the Medical University of Poznań.
- Parkinson’s disease is more common in men, with symptoms appearing at a younger age
- Why are women more protected from getting sick? Female hormones play an important role
- Prof. Kozubski explains when the first signs of the disease may appear
- You can find more such stories on the TvoiLokony home page
Monika Zieleniewska, MedTvoi Studies show that women with Parkinson’s are milder. What factors make them dealt with differently than with men?
Prof. dr hab. Wojciech Kozubski: First of all, this disease is more common in men. The differences are not drastic, but its course is influenced by female hormones – estrogens and progesterone.
Parkinson’s disease in women usually does not progress as quickly as in men, so its course may not be milder, but more prolonged over time. Movement disorders and speech disorders in particular progress more slowly. We observe in practice that women move a little better and speak a little better. Also, non-motor symptoms are not as drastic as in men; I mean dementia and mood disorders. Indeed, the differences can be noticeable, although I repeat, they are not drastic.
What is the incidence rate in women and men?
The difference to the disadvantage of the gentlemen is 3: 2. Noticeably more men are ill and it seems, although we do not have large population studies – ie studies are available, but they cover selected groups of patients, and therefore they are not entirely relevant that the disease attacks men a bit earlier.
And this delay in women can be associated with estrogens?
Most likely yes, they protect to some extent those people who are doomed to Parkinson’s disease from degeneration of the substantia nigra in the brainstem. They show a protective effect against the melatonin cells of the substantia nigra, which degenerate in the dense layer of the substantia nigra. On the other hand, men can only be protected as long as they smoke. Protection is slight, but we’ve known about it for a long time.
In the era of fighting the addiction of smoking, it sounds quite controversial.
The social structure of smoking is changing and a much greater percentage of women smoke. Everyone is smoking less now, but at the same time women are smoking relatively more and getting younger.
Recall that medicine has not fully investigated the causes of Parkinson’s disease.
Not that not really, we don’t know what they are at all. We know relatively much about the pathophysiology of the disease, i.e. changes in dopaminergic impulse between the substantia nigra and the head of the caudate and dopaminergic receptors, as well as the disappearance and degeneration of these receptors. Nevertheless, we do not know what begins the loss of cells in the substantia nigra compact layer.
Since women are protected by oestrogens, do risk factors balance out by the time they go through the menopause?
Maybe they do not completely even out, but the protective effect is weakened. Neither before andropause nor before menopause do we see the very drastic onset of Parkinson’s disease. It usually occurs in the post-menopausal or post-and-endo-menopausal age. On the other hand, the protective effect that oestrogens can exert on a black matter decreases, of course, after the menopause, due to the fact that the pool of these hormones decreases.
And what is the course of the disease in women and men in such a situation?
It is similar, but nevertheless there is still a difference in favor of women. It is small, but it is.
You mentioned that women’s motor disorders progress more slowly.
Indeed, they occur later and their progression is not as rapid as that of men. It is similar with non-motor disorders, i.e. mood disorders or intellectual – cognitive disorders.
head of the Department and Clinic of Neurology at the Medical University of Karol Marcinkowski in Poznań
Is such a complex disorder also treated by specialists from other fields of medicine?
Patients are mainly under the care of a neurologist, but there are also some extra-neurological symptoms.
In a way, that is?
In Poland, he deals with dementia disorders and psychiatry and neurology. Both specialists can show off here.
And do dementia-related disorders affect men or women more?
More gentlemen, though we don’t have hard data. From observations alone, it appears that they are probably more gentlemen. On the other hand, mood disorders are more balanced in both women and men.
There are also sleep disorders …
Yes, of course, they are very characteristic of Parkinson’s disease. It is about agitation and motor symptoms occurring during REM sleep, but we do not observe any particular differences here. Parkinson’s disease sleep disorders are evenly or equitably distributed.
What about olfactory and taste disorders?
They are found in both sexes. In this case, we do not have hard data on the differences.
Can we inherit a predisposition to Parkinson’s disease?
Genetics is a minor risk factor. Family characters are very rare, dominant characters are spontaneous characters.
At what age should we watch for symptoms that could predict Parkinson’s disease?
After 55 years of age. And the disturbing symptoms would be movement disorders, slowness of movement, morning stiffness and – importantly – tremors in one limb – always asymmetric in Parkinson’s disease. And here there are no differences between gentlemen and ladies.
But Parkinson’s can also occur at a young age.
Yes, the symptoms of the disease may appear in people in their thirties. However, in this case as well, it seems that women have a slightly reduced chance of contracting the disease, of course those women who are hormonally active, and at this age they usually are.
Consciousness disorders, fainting, problems with the senses should be consulted with a specialist. Make an appointment with a neurologist
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