Background:
Parkinson disease is a progressive neurological disorder with motor and non-motor symptoms, posing a rising health burden in Pakistan. This study aimed to investigate the age and gender wise distribution of Parkinson disease in Pakistan using a population-based approach.

Methods:
A cross-sectional study was conducted on 437 clinically diagnosed PD patients in twin cities; Rawalpindi and Islamabad from June 2024 to February 2025. Patients presenting with classical symptoms of Parkinson disease (PD) were identified. Those with essential tremor, drug-induced Parkinsonism, extrapyramidal syndromes, or a history of stroke were excluded. Data were collected on patient age, gender, residency, disease severity (based on the Hoehn and Yahr scale), and classical motor symptoms. Statistical analysis was performed to evaluate associations between demographic variables and disease prevalence using chi-square tests, with a p-value <0.05 considered statistically significant.

Results:
Of the 437 patients, 340 (77.8%) were male and 97 (22.2%) were female (p = 0.003). Urban residents comprised 296 (67.7%) of the cohort, while rural residents accounted for 141 (32.3%) (p = 0.001). The majority of PD cases occurred between 51–70 years of age. Stage 3 was the most common severity level in both genders. Rigidity and gait disturbance were the most frequently observed motor symptoms, with significant gender-specific differences noted.

Conclusion:
This study highlights significant age, gender, and residency-based disparities in Parkinson disease prevalence in Pakistan. These findings provide essential baseline data for national-level planning, emphasize the need for early diagnosis, and support the development of targeted interventions, particularly for underserved rural populations.

Index Terms- Parkinson Disease, Epidemiology, Age and Gender Distribution, Neurological Disorder, Prevalence, Population based study