{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T04:57:01Z","timestamp":1784005021617,"version":"3.55.0"},"reference-count":63,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2023,9,1]],"date-time":"2023-09-01T00:00:00Z","timestamp":1693526400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["movementdisorders.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Movement Disorders"],"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>The aim of our study is to analyze sex\u2010specific patterns of Parkinson's disease dementia (PDD) incidence. We are investigating the extent to which sex differences in survival after initial Parkinson's disease (PD) diagnosis influence differences in PDD risk among PD patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We used a random sample of German longitudinal health claims data of persons ages 50+ (2004\u20132019; n\u2009=\u2009250,000) and identified new PD cases ages 65+ who were followed\u2010up for a PDD diagnosis or death between 2006 and 2017. We performed Cox and competing\u2010risk regression models, with death as competing event, to calculate PDD hazard ratios (HR) adjusted for age at PD onset, PD severity as measured by the modified Hoehn and Yahr (HY) scale, comorbidities, and medications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 2195 new PD cases, 602 people died before PDD and 750 people developed PDD by the end of 2017. The adjusted risk of PDD differs by sex, with men having a higher PDD risk than women. When accounting for death, men and women do not differ in their PDD risk (HR\u2009=\u20091.02, <jats:italic>P<\/jats:italic>\u2009=\u20090.770). Sex\u2010specific analyses showed significant age and severity effects in women (age: HR\u2009=\u20091.05, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001; HY 3\u20135 vs. 0\u20132.5: HR\u2009=\u20091.46, <jats:italic>P<\/jats:italic>\u2009=\u20090.011), but not in men.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Older age at first PD diagnosis and higher disease severity increase PDD risk, but this association is attenuated for PD men when controlling for death. This implies that the most frail PD men die rapidly before receiving a dementia diagnosis, whereas women with PD survive at higher rates, regardless of their age at onset and disease severity. \u00a9 2023 The Authors. <jats:italic>Movement Disorders<\/jats:italic> published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.<\/jats:p><\/jats:sec>","DOI":"10.1002\/mds.29596","type":"journal-article","created":{"date-parts":[[2023,9,2]],"date-time":"2023-09-02T00:53:40Z","timestamp":1693616020000},"page":"2041-2052","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["The Impact of Sex\u2010Specific Survival on the Incidence of Dementia in Parkinson's Disease"],"prefix":"10.1002","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2106-2940","authenticated-orcid":false,"given":"Anne","family":"Fink","sequence":"first","affiliation":[{"name":"German Center for 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