Parkinson's Caregivers: More Common for Men than Women?

As Parkinson's disease slowly progresses into a crippling condition that can incapacitate the patient, many require external aid to perform basic tasks like cooking, cleaning after themselves, getting dressed or even getting around.

For these reasons, most patients afflicted with Parkinson’s will need to rely on caregivers to survive at some point in their lives. However, while it was believed that the patients of both genders usually hired caregivers in equal measure, a recent study discovered that women who suffer from Parkinson’s are less likely to receive assistance.

Researchers at the Perelman School of Medicine of the University of Pennsylvania performed a study that highlighted how men are more likely to hire help for their disease than women. This is because a woman's caregiver would often be their spouses, or another family member. So, they wouldn't need to go outside to get aid. They have also found that women who are taken care of by their husbands are more likely to outlive them. 

Parkinson’s is only one out of many neurodegenerative diseases. It currently occupies the second place in terms of frequency, behind only none other than Alzheimer’s Disease. It is present all over the world, affecting individuals of both genders and of all ages, though it is more common after 60 years of age. There exists a late variant of the disease, which manifests long after 60 years of age, as well as an early type of Parkinson’s, manifesting in individuals younger than 40 years old.

Fortunately, Parkinson’s, like other neurodegenerative diseases, is relatively rare, compared to other afflictions, presenting only 18 new cases per 100,000 inhabitants every year. However, the high life expectancy of its patients, made possible by modern medicine, makes the condition’s prevalence significantly higher than its incidence, registering around 164 cases per every 100,000 inhabitants every year.

According to a study sponsored by Europarkinson, the prevalence of Parkinson’s disease in the European continent is of about 1.43% in individuals aged 60 or older, while in other countries such as the United States and the United Kingdom, this figure is a bit lower. Currently, the prevalence of the disease in North American countries is of around 1% in individuals over 65 years of age. However, there are several regions where a spike in Parkinson’s is observed, mainly in rural zones where the population might be exposed to certain environmental risk factors such as contaminated water, pesticides, and insecticides.

As was mentioned, the majority of the disease’s symptoms manifest due to the degeneration and destruction of dopaminergic neurons located in the substantia nigra, along with the subsequent formation of Lewy bodies in their place. The alteration in levels of alpha-synuclein and the accumulation of this substance in the newly-formed Lewy bodies can affect other zones and neural systems, such as the cholinergic, noradrenergic, and serotonergic systems. Consequently, the person can be diagnosed with Parkinson’s if they meet at least 2 of the following symptoms:

• Excessive shaking and tremors while idle
• Muscular Hypertonia
• Bradykinesia, or a distinct sluggishness in beginning or finishing certain movements
• Loss of postural reflexes
• Head tremors

These physical symptoms can, in turn, indirectly affect the individual’s psyche, causing symptoms such as depression, anxiety, and apathy, alongside sleep disorders, cognitive alterations, sensory afflictions, anosmia, and diminished autonomous functionality.

Parkinson’s and Caregivers

Those who suffer from Parkinson’s will, at some point, rely on a caregiver to assist them in performing daily tasks. However, as it turns out, despite some of them being able to rely on their husbands to receive support, single or divorced women who suffer from Parkinson’s might be less likely to receive family support for their disease than men.

This comes as an important issue, considering that the care and support provided by family members are an important source of respite from the disease, and failure to receive said care may complicate and already-too-complex condition.

The study in question that made the startling discovery was part of a much bigger initiative funded by the National Parkinson’s Foundation and that has existed since 2009. Spanning over 20 medical centers, including Penn Medicine, as well as other facilities from 4 countries including Canada, the United States, Netherlands, and Israel, the analysis studied over 7.200 patients up until 2014 when it concluded.

During its course, researchers discovered that 88.4 percent of male patients had a caregiver, which was higher than women’s 79.4 percent. Furthermore, male patients were more likely to have their first medical visit accompanied by a caregiver, compared to females, despite the caregivers of the latter group expressing less psychological strain than the former.

While the study did not address the causes behind these disparities (the findings were a fortunate byproduct), it allowed researchers to establish a common factor between these individuals, and women who suffered from other disabling conditions; females are simply less likely to receive support from friends and family than men.

By analyzing certain statistics, researchers were able to extrapolate several hypotheses from these figures. For starters, women tend to live longer than men, which means that they will likely outlive their spouses. If Parkinson’s manifest after the individual’s spouse has passed, it is possible that they will not receive sufficient support or care.

Furthermore, it is also apparent that women, more so than men, are natural caregivers, which means that even when afflicted with Parkinson’s or other conditions, they are less likely to receive care from their spouses. This fact is further made clear when considering that over 84 percent of male subjects referred their wives as primary caregivers, compared to only 67 percent of women that expressed the same.

The study concludes by expressing that a change in health policies is necessary so that older disabled women can receive appropriate care; if not from family, then from competent caregivers.