Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, China National Clinical Research Center for Neurological Diseases, No. 119 Nansihuan Xilu, Fengtai, Beijing, 100070, China.
Department of Neurology, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
Biol Sex Differ. 2022 Oct 1;13(1):55. doi: 10.1186/s13293-022-00464-w.
Research on sex ratios of Lewy body dementia is controversial, established in small samples, and rarely focused on prodromal stage. The objective is to investigate the clinical sex ratios (men/women) and their associations with clinical features among individuals with mild cognitive impairment with Lewy bodies (MCI-LB), dementia with Lewy bodies (DLB), Parkinson's disease with mild cognitive impairment (PD-MCI), and Parkinson's disease with dementia (PDD) in China.
We conducted a multicenter cohort study, including 1038 individuals with probable MCI-LB, DLB, PD-MCI, or PDD diagnosis from 22 memory clinics in China from January 2018 to March 2022, and recorded their demographic and clinical data by reviewing medical records. Descriptive and regression analyses were used to calculate the sex ratio (men/women), and its associations with demographic and clinical data.
In this study, men comprised 35.14% (men/women sex ratio = 0.54) for MCI-LB, 46.72% (men/women sex ratio = 0.88) for DLB, 63.56% (men/women sex ratio = 1.74) for PD-MCI, and 52.40% (men/women sex ratio = 1.10) for PDD. Sex ratios roughly increased with age. Men had more parkinsonism (p = 0.000) and less fluctuating cognition (p = 0.024) in MCI-LB, and those with PD-MCI had more RBD (p = 0.001). Women with PD-MCI had lower MMSE scores (β ± standard error = - 1.24 ± 0.58, p = 0.04), more irritability (0.95 ± 0.46, p = 0.04) and fluctuating cognition (- 3.41 ± 1.31, p = 0.01), and less parkinsonism (- 2.10 ± 0.97, p = 0.03) than men after adjusting for demographic and cardiometabolic conditions.
There were more women in DLB and MCI-LB, and more men in PD-MCI and PDD. The sex distribution, demographic, and clinical characteristics differed, which strengthened the independence and heterogeneity of the four diseases, and indicated sex-sensitive strategies for management of dementia necessary.
关于路易体痴呆性别比的研究存在争议，这些研究样本量较小，且很少关注前驱期。本研究旨在调查中国轻度认知障碍伴路易体（MCI-LB）、路易体痴呆（DLB）、帕金森病伴轻度认知障碍（PD-MCI）和帕金森病伴痴呆（PDD）患者的临床性别比（男性/女性）及其与临床特征的关系。
我们进行了一项多中心队列研究，纳入了 2018 年 1 月至 2022 年 3 月期间来自中国 22 家记忆诊所的 1038 名可能患有 MCI-LB、DLB、PD-MCI 或 PDD 的患者，并通过查阅病历记录了他们的人口统计学和临床数据。采用描述性和回归分析计算性别比（男性/女性），并分析其与人口统计学和临床数据的关系。
本研究中，MCI-LB 患者中男性占 35.14%（男性/女性性别比=0.54），DLB 患者中男性占 46.72%（男性/女性性别比=0.88），PD-MCI 患者中男性占 63.56%（男性/女性性别比=1.74），PDD 患者中男性占 52.40%（男性/女性性别比=1.10）。性别比随年龄大致增加。在 MCI-LB 中，男性帕金森病症状更明显（p=0.000），波动性认知障碍较少（p=0.024），而 PD-MCI 患者 RBD 更多（p=0.001）。PD-MCI 女性患者 MMSE 评分较低（β±标准误=-1.24±0.58，p=0.04），易激惹（0.95±0.46，p=0.04）和波动性认知障碍（-3.41±1.31，p=0.01）更明显，帕金森病症状较轻（-2.10±0.97，p=0.03）。
DLB 和 MCI-LB 中女性更多，PD-MCI 和 PDD 中男性更多。性别分布、人口统计学和临床特征存在差异，这加强了四种疾病的独立性和异质性，表明需要针对痴呆症进行性别敏感的管理策略。
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