Sex Differences in the Neuropsychiatric Symptoms of Patients With Alzheimer's Disease

Abstract

The aim of this study was to describe sex differences in neuropsychiatric symptoms (NPSs) in patients with Alzheimer's disease (AD). Baseline scores on the Cohen-Mansfield Agitation Inventory, Neurobehavioral Rating Scale-Agitation subscale, and the Neuropsychiatric Inventory from patients with AD enrolled in a multicenter trial of citalopram for the treatment of agitation were analyzed. We found not only that patients with AD having agitation were likely to exhibit many other NPSs but also that the women in this study were more likely to exhibit a broader range of NPS than were the men. These results suggest greater heterogeneity in the clinical presentation of women compared to men, and thus in the potential targets for treatment in these patients. Further characterization of sex differences in NPS can inform future efforts aimed at establishing subtypes of patients for whom various treatment approaches will be most appropriate.

Keywords: Alzheimer disease; agitation; behavioral disturbance; gender difference; neuropsychiatric.

Conflict of interest statement

Declaration of Conflicting Interests

The authors declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Dr Porsteinsson is a board member on Data Safety and Monitoring Boards for Quintiles, Functional Neuromodulation, and New York State Psychiatric Institute; participated on a speaker’s bureau for Forest; and developed educational presentations for CME, Inc. Dr Pollock reports being a board member on Data Safety and Monitoring Boards for Lundbeck Canada; is a paid consultant for Wyeth; and has received travel and accommodation expenses from Lundbeck International Neuroscience Foundation. Dr Porsteinsson is a paid consultant for Elan, Janssen Alzheimer Initiative, and Pfizer. Dr Ismail reports being paid for lectures by Calgary Foothills Primary Care Network, Calgary West Central Primary Care Network, Canadian Conference on Dementia, Alberta College of Family Physicians, and University of British Columbia and is a paid consultant for Astra Zeneca, Janssen, Lundbeck, Otsuka, Pfizer, and Sunovion. Dr Rabins reports being paid for legal testimony from Janssen. Dr Devanand is employed by Roper St. Francis Healthcare, Medical University of South Carolina, Ralph H. Johnson VA Medical Center, and NeuroQuest and is founder of BioPharma Connex. Dr Rosenberg is a paid consultant for Janssen and Pfizer and has developed educational presentations for Eli Lilly. Dr Schneider reports being a board member on Data Safety and Monitoring Boards for Eli Lilly and Janssen and receiving royalties from Oxford University Press. Dr Munro is a paid consultant for Forest Laboratories, Eli Lilly, Astra Zeneca, Johnson and Johnson, Bristol Myers Squibb and Otsuka, and Abbott and Abbvie.