EVALUATING DIAGNOSTIC TOOL PERFORMANCE AND SEX-SPECIFIC NEUROPSYCHIATRIC DIFFERENCES IN PARKINSON’S DISEASE IN TAIWAN

Neuropsychiatric symptoms are common in Parkinson’s disease (PD) but remain insufficiently characterized, particularly regarding sex-specific differences and the performance of diagnostic tools. This study sought to delineate a comprehensive neuropsychiatric profile of a Taiwanese PD cohort, assess the diagnostic sensitivity of commonly used evaluation tools, and examine their associations with clinical features. We enrolled 92 PD patients and 57 healthy controls, who completed motor evaluations (UPDRS), cognitive tests (MMSE, MoCA, CDR), and mood inventories (BDI‑II, HAM‑D). Dementia and depression were diagnosed using standard criteria.
Dementia was present in 34.8% of PD patients, and depression in 28.3%. Female patients showed poorer cognitive performance (MMSE 25.18 vs. 28.08, p = 0.003; MoCA 21.18 vs. 25.79, p = 0.001) and greater affective and behavioral symptoms (HAM‑D 6.68 vs. 5.02, p = 0.046; NPI 3.95 vs. 1.79, p = 0.018) than males. For dementia detection, clinician-administered MMSE and MoCA demonstrated sensitivities above 90%, whereas the caregiver-rated CDR showed markedly lower sensitivity (25%). For depression, the clinician-rated HAM‑D (88.5% sensitivity) outperformed the self-reported BDI‑II (65.4%). Most neuropsychiatric measures correlated significantly with age, disease duration, and motor severity (UPDRS part III; H&Y stage).
These findings highlight a substantial neuropsychiatric burden in PD and a pronounced female vulnerability in cognitive and affective domains. The superior performance of clinician-administered assessments underscores their value in improving diagnostic accuracy. Routine, comprehensive, and sex-sensitive neuropsychiatric evaluation should be integrated into PD clinical care.