Objective: To assess gender differences in caregiving among patients with Parkinson’s disease (PD).

Background: Prior work shows that women with PD have fewer informal caregiving resources than men (1). However, the underlying reasons for these gender differences are poorly understood.

Method: We surveyed caregivers of PD patients at 15 centers in the United States participating in the Parkinson’s Foundation Parkinson’s Outcomes Project (PF-POP), an ongoing, prospective, observational study of PD.

Results: Caregivers for 199 female and 457 male PD patients completed the survey. 84.9% of men and 78.3% of women had a regular care partner. 28.1% of women and 9.8% of men with no care partner were widowed. Over 90% of caregivers were spouses. Female caregivers were younger (aged 64.9 vs. 67.7; p=0.0001) and worked fewer hours per week outside the home than male caregivers (32.1 vs. 41.3; p=0.010). Male and female caregivers had similar employment status and spent a similar amount of time per week providing care. Female caregivers had more symptoms of depression (depression scale score: 10.6 vs 8.6; p=0.025) and reported more strain (caregiver strain index: 19.7 vs. 14.9; p=0.0008), though caregiver preparedness was similar between men and women. Male caregivers had more access to help from others (59.3% vs. 48.0%; p=0.010), reported higher feelings of satisfaction from caregiving (92.8% vs. 87.2%; p=0.045), and had more time for other family members (73.8% vs. 57.6%; p=0.0001). Male caregivers cared for patients with more advanced Hoehn and Yahr stage. PD patients with female caregivers scored worse on cognitive testing and were more likely to be taking a cognitive enhancing medication (18.8% vs 9.5%, p=0.004).

Conclusion: This nationwide survey evaluated gender differences in caregiving among PD patients. The higher rates of depression and strain among female caregivers, with less time to spend on jobs outside the home and with other family members, may in part be explained by higher rates of cognitive decline among PD patients with female caregivers and the larger support system in place for male caregivers. Addressing these unique needs by gender for caregivers will be important for reducing burden. Further studies are important to determine whether these gender differences in caregiving affect long term health outcomes in PD patients.

References: [1] Dahodwala N, Shah K, He Y, Wu S, Schmidt P, Cubillos F, et al. Sex disparities in access to caregiving in Parkinson disease. Neurology. 2017 Dec 1

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