Gender differences in presentation of behavioral and psychological symptoms in Alzheimer's disease in Taiwan
Gender differences in presentation of behavioral and psychological symptoms in Alzheimer's disease in Taiwan
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DOI：
10.1080/13607863.2019.1590311
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发表时间：
2019-03-24
影响因子：
3.4
通讯作者：
Yang, Yuan-Han
中科院分区：
文献类型：
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作者：
Hsieh, Sun-Wung;Chen, Chun-Hung;Yang, Yuan-Han
目的：阿尔茨海默病(AD)患者常出现痴呆的行为和心理症状，尤其是在晚期。据报道，BPSD与性别有关，因为它的生物学特征和痴呆症的严重程度。本研究旨在探讨台湾地区阿尔茨海默病患者BPSD呈现的性别差异。方法：根据美国国家神经疾病与卒中研究所(NINCDS)-阿尔茨海默病及相关疾病协会(ADRDA)标准招募临床诊断为AD的患者。采用人口学数据和年度心理测量学，包括简易精神状态检查(MMSE)、临床痴呆量表(CDR)和神经精神病学问卷(NPI)，包括妄想、幻觉、攻击性、抑郁、焦虑、兴高采烈、冷漠、去抑制、易怒、异常运动、夜间行为和进食等子项，以评估BPSD。对每个招募的AD受试者进行载脂蛋白E(APOE)等位基因分型。比较了性别和变量之间的差异，确定了与性别相关的显著NPI子项，并将线性回归分析确定为BPSD的独立因素。结果：共有280名女性和180名男性AD患者进入统计分析。男性受教育年限较长，MMSE得分高于女性。女性存在较高的妄想性和去抑制性。在线性回归分析中，女性和病程是影响妄想(女性，B=0.95，95%CI=0.17~1.73，p=0.017)和去抑制(女性，B=0.49，95%CI=0.08~0.90，P=0.019)的两个独立因素。结论：BPSD患者的妄想和去抑制表现与女性性别和AD分期有关。去抑制与阿尔茨海默病晚期不一定相关。
Objectives: Behavioral and psychological symptoms of dementia (BPSD) are frequently met in Alzheimer's disease (AD), especially in their late stages. BPSD has been reported to be associated with gender for its biological characteristics and severity of dementia. We aimed to investigate the gender differences in presentation of BPSD in AD in Taiwan. Methods: We recruited patients with clinically diagnosed AD by National Institute of Neurological Disorders and Stroke (NINCDS) - Alzheimer's Disease and Related Disorders Association (ADRDA) criteria. Demographic data and annual psychometrics, including Mini-Mental State Examination (MMSE), Clinical Dementia Rating (CDR) and Neuropsychiatric Inventory (NPI), consisting sub-items of delusions, hallucinations, aggression, depression, anxiety, elation, apathy, disinhibition, irritability, aberrant motor, nighttime behavior and eating were all administered to evaluate BPSD. Apolipoprotein E (APOE) allele was genotyped for each recruited AD subject. Differences between gender and variables were compared and significant NPI sub-items associated with gender were determined, while linear regression analyses were determined as the independent factor for BPSD. Results: In total, 280 female and 180 male AD patients were recruited into statistical analyses. Males had longer education duration and higher MMSE scores than females. Female had higher presence of delusion and disinhibition. In linear regression, being female and CDR stage were two independent factors for delusion (for female, B = 0.95, 95% CI = 0.17-1.73, p = 0.017) and disinhibition (for female, B = 0.49, 95% CI = 0.08-0.90, p = 0.019) after adjusting for confounding factors. Conclusions: The presentation of delusion and disinhibition in BPSD is associated with the female gender and staging of AD. Disinhibition was not necessarily associated with late stage of AD.