老年综合征中精神疾病和神经系统疾病在住院泰国老年患者中的性别差异。

Gender differences in geriatric syndromes as mental illness and nervous system diseases in hospitalized Thai older patients.

机构信息

Department of Healthcare Administration Specialty in Psychology, College of Medical and Health Science, Asia University, Taichung City, Taiwan.

Professor of School of Educational Science, Nantong University, Nantong, China.

出版信息

Psychogeriatrics. 2021 Jul;21(4):453-465. doi: 10.1111/psyg.12679. Epub 2021 Apr 13.

DOI:10.1111/psyg.12679

PMID:33847418

Abstract

BACKGROUND

Older persons are affected by mental and neurological disorders differently, and gender plays a significant role influencing geriatric disorder differentiation. Accordingly this study characterized gender differences in geriatric syndromes among hospitalized elderly Thai patients.

METHODS

Probabilities of disease occurrence reflecting gender differences were calculated using historical data obtained from the Ministry of Public Health website, Thailand. We selected older patients aged 60 years and above admitted to inpatient departments in public hospitals with mental disorders and nervous system diseases from 2014 to 2018, counting over 160 000 cases each year. Descriptive statistics and odds ratios (ORs) were used to analyse and demonstrate gender differences.

RESULTS

Compared to older females, older males had higher occurrences of four mental disorders revealed by OR and 95% confidence interval (CI) values: substance abuse (5.74, 5.08-6.49), alcohol use (5.66, 5.44-5.89), behavioural problems (1.34, 1.31-1.37), and schizophrenia (1.10, 1.06-1.14). Lower incidences for older males were seen in the same values for three mental disorders: neurotic issues (0.46, 0.44-0.49), mood disorders (0.58, 0.56-0.60), and dementia (0.91, 0.88-0.94). For neurological disorders, men had similar higher incidences for epilepsy (1.67, 1.63-1.72), cerebral palsy (1.61, 1.57-1.65), nervous system inflammatory diseases (1.53, 1.46-1.60), ischaemic attacks (1.42, 1.36-1.48), miscellaneous other nervous disorders (1.20; 1.18-1.22), and Parkinson's disease (1.15, 1.12-1.19). By contrast, older men had lower incidences of multiple sclerosis (0.55, 0.35-0.86), migraines (0.66, 0.62-0.70), and Alzheimer's disease (0.75, 0.71-0.78).

CONCLUSION

Accurate characterization of gender differences in geriatric syndromes can better inform policies for appropriate early detection and prevention, and contribute to the development of treatment and intervention for various issues affecting elderly men and women's health.

摘要

背景

老年人受精神和神经障碍的影响不同，而性别在影响老年障碍区分方面起着重要作用。因此，本研究描述了住院老年泰国患者中性别差异的老年综合征。

方法

使用从泰国公共卫生部网站获得的历史数据计算反映性别差异的疾病发生概率。我们选择了 2014 年至 2018 年期间在公立医院住院的年龄在 60 岁及以上的患有精神障碍和神经系统疾病的老年患者，每年有超过 160000 例。使用描述性统计和优势比 (OR) 进行分析和展示性别差异。

结果

与老年女性相比，老年男性的四种精神障碍发生率更高，OR 和 95%置信区间 (CI) 值为：物质滥用 (5.74, 5.08-6.49)、酒精使用 (5.66, 5.44-5.89)、行为问题 (1.34, 1.31-1.37)和精神分裂症 (1.10, 1.06-1.14)。老年男性的三种精神障碍发生率较低：神经症问题 (0.46, 0.44-0.49)、情绪障碍 (0.58, 0.56-0.60)和痴呆症 (0.91, 0.88-0.94)。对于神经系统疾病，男性的癫痫发作 (1.67, 1.63-1.72)、脑瘫 (1.61, 1.57-1.65)、神经系统炎症性疾病 (1.53, 1.46-1.60)、缺血性发作 (1.42, 1.36-1.48)、其他神经障碍 (1.20; 1.18-1.22)和帕金森病 (1.15, 1.12-1.19)发生率相似。相比之下，老年男性多发性硬化症 (0.55, 0.35-0.86)、偏头痛 (0.66, 0.62-0.70)和阿尔茨海默病 (0.75, 0.71-0.78)的发病率较低。