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P3‐130: Sex differences in neuropsychiatric symptoms in MCI and risk of dementia
Author(s) -
Forrester Sarah N.,
Leoutsakos Jeannie-Marie S.
Publication year - 2015
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2015.06.998
Subject(s) - asymptomatic , apathy , dementia , hazard ratio , anxiety , depression (economics) , psychiatry , medicine , psychology , clinical psychology , cognition , disease , confidence interval , economics , macroeconomics
Background: Neuropsychiatric symptoms (NPS) increase the likelihood of progression from Mild Cognitive Impairment (MCI) to dementia. Some studies have shown higher levels of depression, anxiety, and delusions in female patients and higher levels of apathy and aggression in male patients. The objective of the present study is to establish classes of patients with incident MCI based on their neuropsychiatric symptoms. Further we sought to determine if the class structure is different between male and female patients and how class membership relates to risk of progression to dementia formale and femalepatients separately.Methods:Longitudinal data from540 patients with MCI from 29 Alzheimer Disease Centers was utilized. Latent Class and Survival Analyses were used to predict hazard of progression to dementia based on neuropsychiatric symptoms measured using the Neuropsychiatric Inventory (NPI). Analyses were conducted separately by sex to determine if men and women had different class structures and hazard of progression. Results:Class structure varied as a function of sex. An asymptomatic class (75%) and an affective class (25%)were found for men while an asymptomatic class (56%), an affective class (37%), and a severe class (7%) were found for women. For men, the affective class had a hazard ratio of 1.93 (CI: 0.91-4.14) of progression to dementia compared to the asymptomatic class. For women, the severe class was more than three times as likely to progress to dementia as the asymptomatic class (HR: 3.79, CI: 2.01-7.13) and the affective class was nearly twice as likely as the asymptomatic class to progress to dementia (HR: 1.82, CI: 1.11-2.98). Conclusions: The results suggest that men and women have different neuropsychiatric profiles and that these profiles confer different risks of progression to dementia. Understanding how neuropsychiatric symptom patterns different for men and women may lead to better treatment of thosewithNPS and could be an avenue of delaying onset of dementia for each gender. The results may suggest differing etiologies for MCI with NPS by gender based on the most prominent behavioral symptoms for each group. Future research might focus on this area in order to assist in preventative efforts.