In a large online cohort (n≈29,800) the authors report that unemployment/retirement and lower household income are associated with worse motor severity, greater depressive symptoms, and poorer quality of life in Parkinson's disease, while income was not linked to self-reported cognitive complaints.

Although it offers little direct mechanistic or druggable insight, the study highlights socioeconomic factors as important confounders for clinical outcomes, trial design, patient stratification, and non-pharmacologic interventions that can influence therapeutic development and access.

INTRODUCTION: Socioeconomic factors such as employment status and household income may influence clinical outcomes in Parkinson's disease, yet their associations with both motor and non-motor symptoms are not well characterized. This study examined whether employment status and income are associated with cognitive complaints, depressive symptoms, health-related quality of life, and motor severity among individuals with Parkinson's disease. METHODS: Data were obtained from FoxInsight, and online longitudinal cohort study. Participants aged 40 years and older with Parkinson's disease who completed self-report questionnaires were included (n = 29,826). Multilevel models examined associations between employment status and household income with cognitive complaints, depressive symptoms, health-related quality of life, and motor severity across up to three annual assessments. RESULTS: Employment status was significantly associated with all outcomes. Compared with full-time employment, unemployment and retirement were associated with more cognitive complaints, greater depressive symptoms, poorer health-related quality of life, and greater motor severity (all p < 0.05). Part-time employment was generally associated with fewer depressive symptoms and did not significantly differ from full-time employment on several outcomes. Lower household income was significantly associated with greater depressive symptoms, poorer health-related quality of life, and greater motor severity (all p < 0.05), but was not associated with cognitive complaints. CONCLUSION: Employment status and household income are important social determinants of both motor and non-motor outcomes in Parkinson's disease. These findings highlight the potential clinical relevance of socioeconomic factors shaping disease experience and emphasize the need for interventions that address economic and occupational vulnerability.