Gender Differences in Clinical Manifestations and Outcomes Among Hospitalized Patients With Behavioral and Psychological Symptoms of Dementia

Kitamura, Tatsuru; Kitamura, Masaru; Hino, Shoryoku; Tanaka, N; Kurata, Kouichi

doi:10.4088/jcp.11m07614

Cited by 58 publications

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“…In a previous study [12] on hospitalized patients with BPSD, we found that the profile of men at the time of admission was different to that of women: specifically, men were younger, more frequently had vascular dementia, were more frequently admitted from medical hospitals, had lower MMSE and N-ADL scores, were more frequently admitted because of combative behavior, and exhibited aggressiveness and diurnal rhythm disturbances on the BEHAVE-AD. These factors have been shown in the present study to be potentially associated with a longer period of hospitalization.…”

Section: Discussionmentioning

confidence: 96%

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Predictors of Time to Discharge in Patients Hospitalized for Behavioral and Psychological Symptoms of Dementia

Kitamura

Hino

et al. 2013

Dement Geriatr Cogn Disord Extra

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Background/Aims: In Japan, more than 50,000 patients with dementia are housed in psychiatric facilities, a trend precipitated by prolonged hospitalizations. This study aimed to determine predictors for the time to discharge in patients hospitalized for behavioral and psychological symptoms of dementia (BPSD). Methods: Medical charts of patients admitted to an acute psychogeriatric ward for treatment of BPSD were reviewed. Cox's proportional hazards model was used to evaluate relationships between active behavioral problems and/or demographics at the time of admission, and the time until favorable discharge (FD), defined as discharge to the patient's own home or a care facility. Results: For the 402 study patients included in this study, median time to FD was 101 days. In addition to family and residential factors, multivariate analysis identified higher Mini-Mental State Examination scores as independent clinical predictors for a shorter hospital stay, whereas male gender and combative behavior as the primary reason for hospital admission were predictors for a longer hospital stay. Conclusion: Clinical characteristics can be predictive of the time to discharge for patients with BPSD. Earlier interventions and enhanced care strategies may be needed for patients with a lower likelihood of FD.

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Section: Discussionmentioning

confidence: 96%

“…UFDs were defined as death during hospitalization or patient transfer to a medical hospital because of their deteriorating physical condition [12]. …”

Section: Methodsmentioning

confidence: 99%

Predictors of Time to Discharge in Patients Hospitalized for Behavioral and Psychological Symptoms of Dementia

Kitamura

Hino

et al. 2013

Dement Geriatr Cogn Disord Extra

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“…The prevalence of behavioral symptoms might explain the observed difference between men and women. Previous studies have reported that women experience behavioral symptoms, especially depressive symptoms, more frequently than men [14, 45, 46]. We compared the prevalence of behavioral symptoms in the US cohort and only depression and dysphoria were more frequently reported by women.…”

Section: Discussionmentioning

confidence: 99%

A Comparison of Sex Differences in Psychotropic Medication Use in Older People with Alzheimer’s Disease in the US and Finland

et al. 2016

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Aims Given the high prevalence of psychotropic medication use in people with dementia and the potential for different prescribing practices in men and women, our study aimed to investigate sex differences in psychotropic medication use in older adults with Alzheimer's disease (AD) living in the US and Finland. Methods We used data collected between 2005 and 2011 as part of the National Alzheimer's Coordinating Center (NACC) in the US, and Medication use and Alzheimer's disease (MEDALZ) cohorts in Finland. We evaluated psychotropic medication use (antidepressant, antipsychotic, anxiolytic, sedative, or hypnotic) in participants aged 65 years or older. We employed multivariable logistic regression adjusted for demographics, co-morbidities, and other medications to estimate the magnitude of the association (adjusted odds ratio [aOR] with 95% confidence intervals [CIs]) according to sex. Results We included 1099 NACC participants (502 [45.68%] men, 597 [54.32%] women), and 67,049 participants from the MEDALZ cohort (22,961 [34.24%] men, 44,088 [65.75%] women). Women were more likely than men to use psychotropic medications: US, 46.2% vs. 33.1%, p < 0.001; Finland, 45.3% vs. 36.1%, p < 0.001; aOR was 2.06 (95% CI 1.58–2.70) in the US cohort and 1.38 (95% CI 1.33–1.43) in the Finnish cohort. Similarly, of the different psychotropic medications, women were more likely to use antidepressants (aOR-US: 2.16 [1.44–3.25], Finland: 1.52 [1.45–1.58]) and anxiolytics (aOR-US: 2.16 [1.83–3.96], Finland: 1.17 [1.13-1.23]) than men. Conclusionl Older women with AD are more likely to use psychotropic medications than older men, regardless of study population and country. Approaches to mitigate psychotropic medication use need to consider different prescribing habits observed in older women vs. men with AD.

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“…Moreover, our data suggest that RIG-1 signaling activation results in increased expression of APP and Aβ, and that in addition Aβ contributes to the expression of RIG-1. It is important to consider that this study used samples from individuals in the MCI group that had a slightly greater number of females and a wider age range; thus, when interpreting these results one must take into account the effects of gender and age [40]. …”

Section: Discussionmentioning

confidence: 99%

RIG-1 receptor expression in the pathology of Alzheimer’s disease

Vaccari

Brand

Sedaghat

et al. 2014

J Neuroinflammation

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BackgroundNeuroinflammation plays a critical role in the pathogenesis of Alzheimer’s disease (AD) and involves activation of the innate immune response via recognition of diverse stimuli by pattern recognition receptors (PRRs). The inflammatory inducers and precise innate signaling pathway contributing to AD pathology remain largely undefined.ResultsIn the present study we analyzed expression levels of innate immune proteins in temporal and occipital cortices from preclinical (no cognitive impairment, NCI, N = 22) to mild cognitive impairment (MCI, N = 20) associated with AD pathology (N = 20) and AD patients (N = 23). We found that retinoic acid-inducible gene-I (RIG-1) is significantly elevated in the temporal cortex and plasma in patients with MCI. In addition, primary human astrocytes stimulated with the RIG-1 ligand 5′ppp RNA showed increased expression of amyloid precursor protein (APP) and amyloid-β (Aβ), supporting the idea that RIG-1 is involved in the pathology of MCI associated with early progression to AD.ConclusionThese findings suggest that RIG-1 may play a critical role in incipient AD.

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Gender Differences in Clinical Manifestations and Outcomes Among Hospitalized Patients With Behavioral and Psychological Symptoms of Dementia

Abstract: The data demonstrated gender differences in BPSD and outcomes among hospitalized patients. The findings should be considered when deciding on the optimal management plan for patients with BPSD.

Cited by 58 publications

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Predictors of Time to Discharge in Patients Hospitalized for Behavioral and Psychological Symptoms of Dementia

Predictors of Time to Discharge in Patients Hospitalized for Behavioral and Psychological Symptoms of Dementia

A Comparison of Sex Differences in Psychotropic Medication Use in Older People with Alzheimer’s Disease in the US and Finland

RIG-1 receptor expression in the pathology of Alzheimer’s disease

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