Sex Differences in Phenomenology of Behavioral and Psychological Symptoms of Dementia
Bibliographic record
Abstract
INTRODUCTION: 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 AD living in long-term care homes or admitted to inpatient psychiatric units. METHODS: Data were obtained from the Standardizing Care for Neuropsychiatric Symptoms and Quality of Life in Dementia (StaN) study (ClinicalTrials.gov/NCT03672201). BPSD were assessed using the Neuropsychiatric Inventory-Clinician rating scale (NPI-C), and symptom clusters were clustered as follows: (1) psychosis (hallucinations and delusions), (2) emotional distress cluster A (depression and anxiety), (3) emotional distress cluster B (depression, anxiety, and apathy), and (4) agitation (agitation, aggression, irritability, aberrant motor behavior, and aberrant vocalizations). Sex differences in frequency and severity of individual BPSD and clusters were compared using chi-square and Mann-Whitney U tests and generalized linear models while controlling for age and place of residence. RESULTS: Females had higher frequency (males = 21.7% vs. females = 42.9%, χ2 = 8.83, N = 174, p = 0.003) and greater severity of delusions (mean [SD] males = 51.87 [44.15], mean [SD] females = 67.93 [70.53], U = 2,924, N = 174, p = 0.002). Males had higher frequency (males = 51.8% vs. females = 27.5%, χ2 = 10.80, N = 174, p = 0.001) and greater severity of sleep disorders (mean [SD] males = 2.94 [4.21], mean [SD] females = 1.76 [3.92], U = 2,885.50, N = 174, p = 0.002). After controlling for age and residence, sex differences remained significant for delusions (Wald χ2 = 3.97, N = 176, p = 0.046), but not for sleep disorders. There were no sex differences in the frequency or severity of any BPSD clusters. CONCLUSIONS: 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 in screening, and for individualized sex-specific 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 | 0.000 |
| 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) | 0.003 | 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".