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PD is linked to faster brain aging. Sex is recognized as an important factorin PD, such that males are twice as likely as females to have the disease andhave more severe symptoms and a faster progression rate. Despite previousresearch, there remains a significant gap in understanding the function of sexin the process of brain aging in PD patients. The T1-weighted MRI-drivenbrain-predicted age difference was computed in a group of 373 PD patients fromthe PPMI database using a robust brain-age estimation framework that wastrained on 949 healthy subjects. Linear regression models were used toinvestigate the association between brain-PAD and clinical variables in PD,stratified by sex. All female PD patients were used in the correlationalanalysis while the same number of males were selected based on propensity scorematching method considering age, education level, age of symptom onset, andclinical symptom severity. Despite both patient groups being matched fordemographics, motor and non-motor symptoms, it was observed that males withParkinson's disease exhibited a significantly higher mean brain age-delta thantheir female counterparts . In the propensity score-matched PD male group,brain-PAD was found to be associated with a decline in general cognition, aworse degree of sleep behavior disorder, reduced visuospatial acuity, andcaudate atrophy. Conversely, no significant links were observed between thesefactors and brain-PAD in the PD female group.

Sex-based Disparities in Brain Aging: A Focus on Parkinson's Disease