Sex Differences in Behavioral and Psychological Symptoms in Institutionalized Patients with Advanced Alzheimer’s Disease
Bibliographic record
Abstract
Abstract Background Behavioral and psychological symptoms in dementia (BPSD) are highly prevalent in patients with Alzheimer’s dementia (AD). We examined sex differences in the frequency and severity of BPSD in patients with advanced AD residing in long term care or admitted to inpatient psychiatric units. Also, sex differences in the frequency and severity of BPSD symptom clusters were explored. Method We analyzed data from the Standardizing Care for Neuropsychiatric Symptoms and Quality of Life in Dementia (StaN) study (ClinicalTrials.gov/NCT03672201). BPSD was assessed with the Neuropsychiatric Inventory Clinician rating scale. Chi‐squared tests and Mann‐Whitney U tests were used to determine sex differences in frequency and severity of BPSD, respectively. Bonferroni correction was used for multiple comparisons. Generalized linear models were performed to examine effect of sex on severity of BPSD while controlling for age and residence. BPSD symptom clusters were defined as: (1) psychosis (hallucinations and delusions), (2) emotional distress (depression and anxiety), and (3) agitation (agitation, aggression, irritability, aberrant motor behavior, and aberrant vocalizations). Result 194 participants (99 female, 95 male) were included. Females had higher frequency of delusions (X2(N = 176) = 8.47, p = .004) and males had higher frequency of sleep disturbances (X2(N = 176) = 9.89, p = .002). Further, females had greater severity of delusions (N = 176, U = 2976, p = .001), and sleep disturbances (N = 176, U = 2950, p = .002). In generalized linear models, sex was associated with severity of delusions (Wald X2 = 3.97, N = 176, p = .046), but not with sleep disturbances. Examination of clusters revealed that females had higher frequency of psychosis (X2(N = 176) = 4.25, p = .039). Conclusion We observed sex differences in the frequency and severity of specific BPSD. Future studies should aim to understand potential mechanisms underlying these differences, and to study their relevance for screening, and individualized management of BPSD.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".