Hsieh Sun-Wung, Chen Chun-Hung, Huang Ling-Chun, Chang Yu-Han, Yang Yuan-Han
Department of Neurology, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
Aging Ment Health. 2020 Aug;24(8):1342-1347. doi: 10.1080/13607863.2019.1590311. Epub 2019 Mar 26.
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. 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. 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, = 0.017) and disinhibition (for female, B = 0.49, 95% CI = 0.08-0.90, = 0.019) after adjusting for confounding factors. 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.
痴呆的行为和心理症状（BPSD）在阿尔茨海默病（AD）中很常见，尤其是在晚期。据报道，由于其生物学特征和痴呆严重程度，BPSD与性别有关。我们旨在调查台湾地区AD患者中BPSD表现的性别差异。我们招募了根据美国国立神经疾病和中风研究所（NINCDS）-阿尔茨海默病及相关疾病协会（ADRDA）标准临床诊断为AD的患者。收集人口统计学数据以及年度心理测量数据，包括简易精神状态检查表（MMSE）、临床痴呆评定量表（CDR）和神经精神科问卷（NPI），NPI包含妄想、幻觉、攻击行为、抑郁、焦虑、欣快、冷漠、脱抑制、易怒、异常运动、夜间行为和饮食等子项目，所有这些都用于评估BPSD。对每个招募的AD患者进行载脂蛋白E（APOE）基因分型。比较性别与变量之间的差异，确定与性别相关的显著NPI子项目，同时进行线性回归分析以确定BPSD的独立因素。总共280名女性和180名男性AD患者被纳入统计分析。男性的受教育时间更长，MMSE得分高于女性。女性的妄想和脱抑制表现更为常见。在线性回归中，在调整混杂因素后，女性和CDR分期是妄想（女性，B = 0.95，95%可信区间 = 0.17 - 1.73，P = 0.017）和脱抑制（女性，B = 0.49，95%可信区间 = 0.08 - 0.90，P = 0.019）的两个独立因素。BPSD中妄想和脱抑制的表现与女性性别及AD分期有关。脱抑制不一定与AD晚期相关。
