The first major analysis from the Australian Parkinson's Genetics Study (APGS), led by QIMR Berghofer, has revealed substantial sex‑based differences in how Parkinson's disease manifests and progresses, highlighting the need for more personalised approaches to prevention, diagnosis and care.
Nearly 11,000 people with Parkinson's disease participated in the study, which involved answering a wide-ranging questionnaire on their experience with the condition, and supplying a saliva sample.
The study found women were more likely to experience falls, with 45% reporting them compared to 41% of men. Women also reported higher rates of pain (70% compared to 63%), depression (32% compared to 26%), and anxiety (23%compared to 16%). In contrast, men were more likely to report memory changes,with 67% experiencing them compared to 61% of women, along with higher rates of cognitive impairment. Sleep‑related differences were also pronounced, with men showing high rates of REM sleep
behaviour disorder (12% compared to 7%) and sleep apnoea (19% compared to 9%). Men additionally reported more impulsive behaviours, particularly those related to sexual behaviour.
"These differences tell us that Parkinson's is not a one-size-fits-all disease," said Associate Professor Miguel Rentería, who heads up the Computational Neurogenomics Laboratory at QIMR Berghofer. "The distinct patterns we see in men and women may reflect different underlying biological pathways and environmental exposures. Understanding these differences is essential if we want to move towards truly personalised approaches to prevention, diagnosis, and treatment."
The study found that environmental exposures prior to diagnosis also differed markedly between the sexes. Men reported significantly higher exposure to pesticides - 42% compared with 28% of women - and were far more likely to have worked in high‑risk occupations such as farming, metal work, and petrochemicals. One in four participants reported a family history of Parkinson's, and common environmental factors across the cohort included pesticide exposure (36%) and traumatic head injury (16%).
Whilst the researchers note it's not known yet whether environmental exposure alone can cause Parkinson's disease, the results confirm that certain exposures are more common among people with the condition.
PhD candidate Fangyuan (Elainor) Cao , who led the analysis at QIMR Berghofer, says the scale and depth of the dataset lays the groundwork for Parkinson's disease breakthroughs. "What struck me most was just how varied the experience of Parkinson's is - not only between individuals, but between men and women. The richness of this dataset allows us to move beyond averages and start to understand why the disease looks so different from one person to the next."
Clinician and researcher Associate Professor Kishore Kumar believes the work will help inform and educate doctors about the vastly different ways Parkinson's disease can present. "This cohort is a remarkable national resource that will drive future genetic and longitudinal research and, ultimately, help improve the lives of people living with Parkinson's."
The Shake It Up Australia Foundation, in partnership with the Michael J. Fox Foundation, has supported the expansion of the APGS. CEO Vicki Miller said the findings reinforce the importance of supporting this type of research here in Australia. "Shake It Up Australia has proudly supported the APGS since 2022 because we believe large-scale Australian research is essential to finding better treatments and, ultimately, a cure. Seeing this study grow to become the largest active Parkinson's cohort in the world is extraordinary, and it's a testament to the generosity of the thousands of Australians who gave their time to participate. This is exactly the kind of bold, ambitious research our community needs."
The APGS research team has also completed recruitment of 10,000 Australians without Parkinson's, creating a powerful comparative resource for investigating how genetic and environmental factors influence disease onset and progression. A follow‑up survey is planned for 2026, along with ongoing genomic profiling, to identify new genetic drivers of risk and Parkinson's disease progression.
