Hostname: page-component-586b7cd67f-t7fkt Total loading time: 0 Render date: 2024-11-22T22:20:52.075Z Has data issue: false hasContentIssue false
  • English
  • Français

Sex differences in the prevalence of behavioral and psychological symptoms of dementia

Published online by Cambridge University Press:  26 February 2009

Hugo Lövheim ,
Per-Olof Sandman ,
Stig Karlsson  and
Yngve Gustafson
Hugo Lövheim*
Affiliation:
Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, Umeå, Sweden
Per-Olof Sandman
Affiliation:
Department of Nursing, Umeå University, Umeå, Sweden
Stig Karlsson
Affiliation:
Department of Nursing, Umeå University, Umeå, Sweden
Yngve Gustafson
Affiliation:
Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, Umeå, Sweden
*
Correspondence should be addressed to: H. Lövheim, Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, SE-901 85 Umeå, Sweden. Phone: +46 90 785 88 59; Fax: +46 90 13 06 23. Email: [email protected].
Get access Rights & Permissions [Opens in a new window]

Abstract

Background: When a person has dementia, non-cognitive behaviors and symptoms might constitute a greater problem than the cognitive decline itself. Male or female sex might be a predisposing factor for certain types of behavior disturbances and symptoms. The aim of the present analysis was to explore the correlation between sex and the prevalence of behavioral and psychological symptoms of dementia.

Method: A total of 3395 people with cognitive impairment (1056 men and 2339 women) were selected from two large cross-sectional surveys of those in geriatric care settings, conducted in 1982 and 2000 in the county of Västerbotten, Sweden. Symptoms were assessed using the Multi-Dimensional Dementia Assessment Scale (MDDAS), and prevalence was compared using multivariate logistic regression. Drug data were obtained from prescription records.

Results: For 17 out of 39 behaviors and symptoms, the prevalence differed significantly between men and women. Men more often exhibited aggressive behavior and regressive behaviors, and women more often exhibited depressive symptoms. There were no sex differences for passiveness and hallucinations. The prevalence of antipsychotic drug use was higher among men (35.5% compared to 28.9%, p < 0.001) and antidepressant drug use higher among women (30.1% compared to 25.6%, p = 0.006). The prevalence of use of anxiolytics, hypnotics and sedatives did not differ.

Conclusion: There are some differences in the prevalence of behavioral and psychological symptoms of dementia between men and women. These different symptom profiles might possibly explain some of the differences found in the pharmacological treatment of men and women with a dementia disorder.

Keywords

dementianursing homeBPSDAlzheimer's diseasesex differencesdepressionaggression
Type
Research Article
Information
International Psychogeriatrics , Volume 21 , Issue 3 , June 2009 , pp. 469 - 475
Copyright
Copyright © International Psychogeriatric Association 2009

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Adolfsson, R., Gottfries, C. G., Nyström, L. and Winblad, B. (1981). Prevalence of dementia disorders in institutionalized Swedish old people. The work load imposed by caring for these patients. Acta Psychiatrica Scandinavica, 63, 225–244.Google Scholar
American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental Disorders (4th edn, text revision). Washington, DC: American Psychiatric Association.Google Scholar
Black, W. and Almeida, O. P. (2004). A systematic review of the association between the Behavioral and Psychological Symptoms of Dementia and burden of care. International Psychogeriatrics, 16, 295–315.CrossRefGoogle ScholarPubMed
Brodaty, H., et al. (2001). Psychosis, depression and behavioral disturbances in Sydney nursing home residents: prevalence and predictors. International Journal of Geriatric Psychiatry, 16, 504–512.CrossRefGoogle Scholar
Buchanan, R. J., Wang, S., Ju, H. and Graber, D. (2004). Analyses of gender differences in profiles of nursing home residents with Alzheimer's disease. Gender Medicine, 1, 48–59.Google Scholar
Cohen-Mansfield, J. and Libin, A. (2005). Verbal and physical non-aggressive agitated behaviors in elderly persons with dementia: robustness of syndromes. Journal of Psychiatric Research, 39, 325–332.Google Scholar
Cohen-Mansfield, J., Marx, M. S. and Werner, P. (1992). Agitation in elderly persons: an integrative report of findings in a nursing home. International Psychogeriatrics, 4 (Suppl. 2), 221–240.CrossRefGoogle ScholarPubMed
Eastley, R. and Wilcock, G. K. (1997). Prevalence and correlates of aggressive behaviors occurring in patients with Alzheimer's disease. International Journal of Geriatric Psychiatry, 12, 484–487.3.0.CO;2-#>CrossRefGoogle ScholarPubMed
Folstein, M. F., Folstein, S. E. and McHugh, P. R. (1975). “Mini-mental state”: a practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189–198.Google Scholar
Hall, K. A. and O'Connor, D. W. (2004). Correlates of aggressive behavior in dementia. International Psychogeriatrics, 16, 141–158.Google Scholar
Kallin, K., Gustafson, Y., Sandman, P. O. and Karlsson, S. (2004). Drugs and falls in older people in geriatric care settings. Aging Clinical and Experimental Research, 16, 270–276.Google Scholar
Lam, C. L., Chan, W. C., Mok, C. C., Li, S. W. and Lam, L. C. (2006). Validation of the Chinese Challenging Behavior Scale: clinical correlates of challenging behaviors in nursing home residents with dementia. International Journal of Geriatric Psychiatry, 21, 792–799.CrossRefGoogle ScholarPubMed
Lövheim, H., Sandman, P. O., Kallin, K., Karlsson, S. and Gustafson, Y. (2006). Relationship between antipsychotic drug use and behavioral and psychological symptoms of dementia in old people with cognitive impairment living in geriatric care. International Psychogeriatrics, 18, 713–726.CrossRefGoogle ScholarPubMed
Lövheim, H., Sandman, P., Kallin, K., Karlsson, S. and Gustafson, Y. (2008a). Symptoms of mental health and psychotropic drug use among old people living in geriatric care, changes between 1982 and 2000. International Journal of Geriatric Psychiatry, 23, 289–294.CrossRefGoogle ScholarPubMed
Lövheim, H., Sandman, P. O., Karlsson, S. and Gustafson, Y. (2008b). Behavioral and psychological symptoms of dementia in relation to level of cognitive impairment. International Psychogeriatrics, 20, 777–789.CrossRefGoogle ScholarPubMed
Matsuoka, K., Miyamoto, Y., Ito, H. and Kurita, H. (2003). Relationship between behavioral disturbances and characteristics of patients in special units for dementia. Psychiatry and Clinical Neuroscience, 57, 569–574.Google Scholar
Menon, A. S. et al. (2001). Relationship between aggressive behaviors and depression among nursing home residents with dementia. International Journal of Geriatric Psychiatry, 16, 139–146.Google Scholar
Neri, M., Bonati, P. A., Pinelli, M., Borella, P., Tolve, I. and Nigro, N. (2007). Biological, psychological and clinical markers of caregiver's stress in impaired elderly with dementia and age-related disease. Archives of Gerontology and Geriatrics, 44 (Suppl. 1), 289–294.CrossRefGoogle ScholarPubMed
Neville, C. C. and Byrne, G. J. (2006). The impact of residential respite care on the behavior of older people. International Psychogeriatrics, 18, 163–170.Google Scholar
Ott, B. R., Tate, C. A., Gordon, N. M. and Heindel, W. C. (1996). Gender differences in the behavioral manifestations of Alzheimer's disease. Journal of the American Geriatrics Society, 44, 583–587.Google Scholar
Pitkälä, K. H., Laurila, J. V., Strandberg, T. E. and Tilvis, R. S. (2004). Behavioral symptoms and the administration of psychotropic drugs to aged patients with dementia in nursing homes and in acute geriatric wards. International Psychogeriatrics, 16, 61–74.Google Scholar
Ropacki, S. A. and Jeste, D. V. (2005). Epidemiology of and risk factors for psychosis of Alzheimer's disease: a review of 55 studies published from 1990 to 2003. American Journal of Psychiatry, 162, 2022–2030.CrossRefGoogle ScholarPubMed
Sandman, P. O., Adolfsson, R., Norberg, A., Nystrom, L. and Winblad, B. (1988). Long-term care of the elderly. A descriptive study of 3600 institutionalized patients in the county of Vasterbotten, Sweden. Comprehensive Gerontology (A), 2, 120–132.Google Scholar
Schreiner, A. S. (2001). Aggressive behaviors among demented nursing home residents in Japan. International Journal of Geriatric Psychiatry, 16, 209–215.Google Scholar
Shin, I. S., Carter, M., Masterman, D., Fairbanks, L. and Cummings, J. L. (2005). Neuropsychiatric symptoms and quality of life in Alzheimer disease. American Journal of Geriatric Psychiatry, 13, 469–474.CrossRefGoogle ScholarPubMed
Statistics Sweden (2007). Population Statistics. Population by Region, Marital Status, Age and Sex. Year 1968–2006. Örebro: Statistics Sweden.Google Scholar
Steinberg, M. et al. (2006). Risk factors for neuropsychiatric symptoms in dementia: the Cache County Study. International Journal of Geriatric Psychiatry, 21, 824–830.CrossRefGoogle ScholarPubMed
Testad, I., Aasland, A. M. and Aarsland, D. (2007). Prevalence and correlates of disruptive behavior in patients in Norwegian nursing homes. International Journal of Geriatric Psychiatry, 22, 916–921.CrossRefGoogle ScholarPubMed
van Iersel, M., Koopmans, R., Zuidema, S. and Rikkert, M. O. (2004). Do not use “BPSD” if you want to be cited. International Journal of Geriatric Psychiatry, 19, 803–804.CrossRefGoogle ScholarPubMed