Ott B R, Lapane K L, Gambassi G
Department of Clinical Neurosciences Center for Gerontology and Health Care Research, Brown University, Providence, RI, USA.
Neurology. 2000 Jan 25;54(2):427-32. doi: 10.1212/wnl.54.2.427.
To define gender differences in noncognitive behavioral problems of patients with AD and differences in the associated treatment of those problems.
DESIGN/METHODS: We performed an observational study using the Systematic Assessment and Geriatric drug use via Epidemiology (SAGE) database, which contains data collected with the Minimum Data Set on a cross-section of nursing home residents in five US states. Behavior problems were documented at the first assessment of 28,367 residents with AD. We evaluated the role of gender differences in behavior as predictors of differences in nonpharmacologic versus specific pharmacologic therapies with psychoactive medications using logistic regression.
Men were more likely than women to exhibit behavior problems such as wandering, abusiveness, and social impropriety (59% versus 50% for any behavior problem). Hallucinations and delusions as well as depression were equally prevalent in men and women. Nevertheless, men were more likely to receive psychoactive medications. Among the specific drug categories examined, and controlling for age and degree of cognitive impairment, men were more likely to receive antipsychotic drugs and less likely to be receiving antidepressants.
Gender appears to play an important role in determining the frequency of behavioral problems in nursing home residents with AD, which may influence choice of treatments as well as the decision whether to treat. The use of more potent tranquilizers in men with problem behaviors has potential implications for morbidity, deserving further investigation.
确定阿尔茨海默病（AD）患者非认知行为问题中的性别差异以及这些问题相关治疗的差异。
设计/方法：我们使用通过流行病学进行系统评估和老年药物使用（SAGE）数据库进行了一项观察性研究，该数据库包含在美国五个州对养老院居民横断面使用最小数据集收集的数据。对28367名患有AD的居民进行首次评估时记录了行为问题。我们使用逻辑回归评估性别差异在行为方面作为使用精神活性药物的非药物治疗与特定药物治疗差异预测因素的作用。
男性比女性更有可能表现出如徘徊、攻击性和社交不当等行为问题（任何行为问题的发生率分别为59%和50%）。幻觉、妄想以及抑郁在男性和女性中同样普遍。然而，男性更有可能接受精神活性药物治疗。在所检查的特定药物类别中，在控制年龄和认知障碍程度后，男性更有可能接受抗精神病药物治疗，而接受抗抑郁药物治疗的可能性较小。
性别似乎在确定患有AD的养老院居民行为问题的频率方面起着重要作用，这可能会影响治疗选择以及是否进行治疗的决策。对有问题行为的男性使用更强效的镇静剂对发病率有潜在影响，值得进一步研究。
