Title : Sex differences in the neuropsychiatric symptoms of patients with alzheimer’s disease of varying severity
Abstract:
Studies have shown differences in neuropsychiatric symptoms (NPSs) of Alzheimer’s disease?AD? between the
males and females. However, we do not know whether this difference is influenced by disease severity.
Method:
Patients with AD who visited the Memory Clinic from April 2019 to July 2021 were selected. Overall, 279 patients (122 males, 157 females) with mild-AD (MMSE scores 21-26 points, n=38, 18 females), moderate-AD (MMSE score 10-20 points, n=115, 60 females) or severe-AD (MMSE score 0-9 points, n=126, 76 females) were included. We explored the severity of NPS in different sex using the subscales from the Neuropsychiatric Inventory-Questionnaire (NPI-Q), and further identified the correlation between daily living ability and NPS.
Result:
The incidence of NPSs in AD patients increased with the increase of dementia severity. Which the incidence with mild, moderate and severe AD was 73.7%, 90.4% and 98.7%, respectively. Shows the differences in the NPI-Q subscales according to sex and severity. Mann-Whitney U test found that, among the NPI-Q subscales, the severity of motor disturbance(P=0.015) and hallucinations (P=0.016) were significantly higher among females than among males. In the mild AD, The severity of nighttime behaviors(p=0.049), delusions (P=0.001) and motor disturbance (P=0.016) were significantly higher among females than among males. In severe patients, the agitation/aggression (P=0.024) and nighttime behaviors (p=0.009) of females was significantly higher than that of males. While there was no significant difference between genders in NPSs in patients with moderate AD. Spearman correlation analysis showed that ADL was correlated with MMSE score (r=-0.64), total score of NPI and all symptoms except anxiety and depression, but the significance was not strong (r<0.7), indicating a positive correlation.
Conclusion:
There were significant differences in the incidence and score of NPSs among AD patients with different severity. Sex differences and severity differences should be considered when determining the need for NPS interventions.The improvement of NPS symptoms helps to improve patients' ability to perform daily living, especially with nighttime behaviors abnormalities.
Keywords:
Alzheimer’s Disease, Neuropsychiatric Symptoms, Sex Differences, Sex Differences,Disease Severity
Audience Take Away
- How to understand the morbidity of patients from the memory clinic
- Viewers can learn more about the correlation between neuropsychiatric symptoms and disease severity and gender in Chinese Alzheimer's patients
- Other faculty could use to expand their research or teaching
