Silvestri Chiara, Almici Valentina, Libri Ilenia, Mattioli Irene, Cosseddu Maura, Turrone Rosanna, Rivolta Jasmine, Grassini Chiara, Caratozzolo Salvatore, Alberici Antonella, Marengoni Alessandra, Pilotto Andrea, Borroni Barbara, Padovani Alessandro, Benussi Alberto
Department of Clinical and Experimental Sciences (CS, VA, IL, IM, JR, CG, AM, A. Pilotto, BB, A. Padovani, AB), University of Brescia; and Department of Continuity of Care and Frailty (MC, RT, SC, AA), AOU Spedali Civili di Brescia, Italy.
Neurol Clin Pract. 2024 Jun;14(3):e200299. doi: 10.1212/CPJ.0000000000200299. Epub 2024 Apr 18.
Dementia presents not only differing neuropsychiatric symptoms (NPS) across Alzheimer disease (AD), frontotemporal dementia (FTD), dementia with Lewy bodies (DLB) but also subjective cognitive decline (SCD). This study examined sex-based variations in NPS severity and progression across these conditions.
We performed a longitudinal cohort study including 1,068 participants. Hierarchical generalized linear mixed models were used to model NPS as a function of disease severity and biological sex at birth.
Female participants with AD exhibited NPS more frequently than male participants. In FTD, female participants had more frequent delusions, hallucinations, and depression/dysphoria, while male participants had higher instances of agitation/aggression, apathy, disinhibition, and irritability/lability. In DLB, male participants showed higher instances of depression, and female participants more frequently experienced anxiety. In SCD, female participants showed higher nighttime behaviors. The trajectory of NPS significantly differed between sexes.
These findings highlight sex-specific NPS impact in different neurodegenerative conditions.
痴呆不仅在阿尔茨海默病（AD）、额颞叶痴呆（FTD）、路易体痴呆（DLB）中表现出不同的神经精神症状（NPS），还存在主观认知下降（SCD）。本研究调查了这些情况下NPS严重程度和进展的性别差异。
我们进行了一项纵向队列研究，纳入1068名参与者。采用分层广义线性混合模型将NPS作为疾病严重程度和出生时生物学性别的函数进行建模。
患有AD的女性参与者比男性参与者更频繁地出现NPS。在FTD中，女性参与者出现妄想、幻觉和抑郁/烦躁不安的频率更高，而男性参与者出现激越/攻击、冷漠、脱抑制和易怒/情绪不稳定的情况更多。在DLB中，男性参与者出现抑郁的情况更多，而女性参与者更频繁地经历焦虑。在SCD中，女性参与者表现出更多的夜间行为。NPS的轨迹在性别之间存在显著差异。
这些发现突出了不同神经退行性疾病中NPS的性别特异性影响。
