The PRIAMO study: active sexual life is associated with better motor and non-motor outcomes in men with early Parkinson's disease

Background and purpose: Data suggest a relationship between sexual dysfunction, mainly erectile dysfunction in men, and worse disease progression in Parkinson's disease (PD). There is scant evidence on the correlates of sexual activity in PD patients. By involving a subgroup of 355 patients from the PRIAMO (Parkinson Disease Non Motor Symptoms) study, the present 24-month longitudinal prospective analysis aims to demonstrate that the presence of active sexual life is associated with disease progression in early PD. Methods and results: Multivariable mixed-effect logistic regression models showed that gastrointestinal symptoms [odds ratio 0.56, 95% confidence interval (CI) 0.39–0.82, P = 0.003] and apathy (odds ratio 0.42, 95% CI 0.29–0.63, P < 0.001) were less likely to be associated with sexual activity in men. Analysis also demonstrated that sexual activity in men was associated with lower motor disability (coefficient −2.881, 95% CI −4.732 to −1.030, P = 0.002), better quality of life (coefficient −24.196, 95% CI −44.884 to −3.508, P = 0.022; coefficient 0.083, 95% CI 0.023–0.143, P = 0.006) and lower depression scores (coefficient −1.245, 95% CI −2.104 to −0.387, P = 0.004). No association was shown in women. Conclusions: This is the first prospective longitudinal study involving a large cohort of PD patients suggesting that sexual activity is associated with lower motor and non-motor disability as well as with better quality of life in men. These findings should prompt movement disorders specialists to periodically inquiry about their patients’ sexual life.