Sex Differences in Demographic and Pharmacological Factors in Alzheimer Patients With Dementia and Cognitive Impairments

Abstract

ObjectiveThe current study investigates sex differences associated with pharmacological and demographic characteristics in Alzheimer patients (AD) with dementia (ADD) or mild cognitive impairment (MCI).MethodA retrospective analytical approach was used to analyze data from 45,696 AD patients with MCI or ADD. The univariate analysis was used to determine differences in demographic, and pharmacological characteristics for male and female ADD and MCI-AD patients. Multivariate analysis was used to predict specific pharmacological and demographic factors that are associated with male and female MCI and ADD patients.ResultIn the adjusted analysis for male patients, Hispanics [0.166,0.020 – 1.355, P = 0.094] or African Americans [OR = 2.380, 95% CI,2.120 – 2.674, P < 0.001], were more likely to have MCI-AD and be treated with galantamine [OR = 0.559, 95% CI, 0.382 – 0.818, P = 0.003], donepezil [OR = 1.639, 95% CI,1.503 – 1.787, P < 0.001], rivastigmine [OR = 1.394, 95% CI,1.184 – 1.642, P < 0.001], olanzapine [OR = 2.727, 95% CI,2.315 – 3.212, P < 0.001], risperidone [OR = 2.973, 95% CI,2.506 – 3.526, P < 0.001], present with increasing age [1.075,1.071 – 1.079, P < 0.001], and are on tobacco use [OR = 1.150, 95% CI,1.054 – 1.254, P = 0.002]. For female patients, buspirone [OR = 0.767, 95% CI, 0.683 – 0.861, P < 0.001] and a history of alcohol (ETOH) use [OR = 0.484, 95% CI, 0.442 – 0.529, P < 0.001] were associated with MCI-AD. Increasing age [OR = 1.096, 95% CI, 1.093 – 1.100, P < 0.001], donepezil [OR = 2.185, 95% CI, 2.035 – 2.346, P < 0.001], memantine [OR = 2.283, 95% CI, 2.104 – 2.477, P < 0.001] aripiprazole [OR = 1.807, 95% CI, 1.544 – 2.113, P < 0.001] olanzapine [OR = 2.289, 95% CI, 1.986 – 2.640, P < 0.001] risperidone [OR = 2.548, 95% CI, 2.246 – 2.889, P < 0.001] buspirone [OR = 0.767, 95% CI, 0.683 – 0.861, P < 0.001] escitalopram [OR = 1.213, 95% CI,1.119 – 1.315, P < 0.001] African Americans [OR = 1.395, 95% CI, 1.268 – 1.535, P < 0.001] and tobacco use [OR = 1.150, 95% CI, 1.073 – 1.233, P < 0.001] were associated with ADD.ConclusionOur findings reveal that MCI-AD patients were more likely to be Hispanics or African American males treated with rivastigmine, olanzapine and citalopram. African American females were associated with ADD and more likely to be treated with buspirone and presented with a history of ETOH. This finding suggests the need for a pharmacological treatment approach encompassing sex-sensitive strategies for MCI-AD and ADD patients.

Meta-Analysis of the Efficacy and Safety of Olanzapine versus Clozapine when Treating Senile Dementia

“…Total events Heterogeneity: Chi 2 = 3.36, df = 5 (P = 0.64); I 2 = 0% Test for overall effect: Z = 1.38 (P = 0.17) Test for subgroup differences: Chi 2 = 0.02, df = 2 (P = 0.99); I 2 = 0% Computational and Mathematical Methods in Medicine receptors, as well as dopamine and choline. It can antagonize and even selectively reduce the firing of dopaminergic neurons in the limbic system (A10), while having little effect on the motor function pathway of the striatum (A9) [25][26][27]. Meta-analysis showed that the clinical efficacy was similar and there was no significant difference between olanzapine and clozapine in the treatment of mental and behavioral disorders in patients with AD.…”

Sex Differences in the Preventive Effect of Cardiovascular and Metabolic Therapeutics on Dementia

“…ChEIs reduce the breakdown of acetylcholine in the brain, preserving cognitive functions and improving the cognitive, behavioral, and neuropsychiatric symptoms of AD ( Coker-Ayo et al ., 2022 ). Patients diagnosed with mild-to-moderate AD are prescribed galantamine, rivastigmine, and/or donepezil as first-line therapeutics ( Calabria et al ., 2009 ).…”

“…Galantamine is also used to treat mild cognitive impairment (MCI) in Hispanic men, while it is used to treat MCI-AD in African-American women. These differences in sex demographics and ethnicity highlight the importance of tailoring treatment for patients diagnosed with AD ( Coker-Ayo et al ., 2022 ).…”

Bright Morning Lighting Enhancing Parasympathetic Activity at Night: A Pilot Study on Elderly Female Patients with Dementia without a Pacemaker

“…Notably, more women are affected by dementia than men. Overall, twice as many women have dementia compared to Alzheimer’s disease [ 2 ]. Menopause affects the secretion of sex hormones in women, such as progesterone, testosterone, and estrogen levels, which increases the risk of dementia in menopausal women.…”

“…Menopause affects the secretion of sex hormones in women, such as progesterone, testosterone, and estrogen levels, which increases the risk of dementia in menopausal women. Based on estrogen and progestin medroxyprogesterone acetate, researchers have proposed the “healthy cell hypothesis” in which estradiol exerts neuroprotective effects [ 2 , 3 ]. Dementia is a neurodegenerative process that affects memory, social behavior, activities of daily living, and sleep; reduced nocturnal parasympathetic activity may represent early predictive factors for progression to dementia [ 4 ].…”