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

J Clin Psychiatry 2012;73(12):1548-1554
10.4088/JCP.11m07614

Objective: To clarify whether hospitalized patients with behavioral and psychological symptoms of dementia (BPSD) show gender differences in manifested symptoms and outcomes.

Method: A chart review study of patients hospitalized from April 2006 to March 2008 for the treatment of BPSD was conducted. We evaluated the prevalence of symptoms in each of 7 clusters constituting a subscale of the Behavioral Pathology in Alzheimer’s Disease Rating Scale and the incidence of favorable discharge, defined as discharge to the patient’s own home or care facility. Dementia was diagnosed according to DSM-IV.

Results: The study cohort comprised 122 men and 170 women. The men were more likely than the women to present with aggressiveness (78% vs 52%, P < .001) and diurnal rhythm disturbances (89% vs 79%, P < .05) and less likely to present with paranoid, delusional ideation (12% vs 41%, P < .001); hallucination (7% vs 29%, P < .001); affective disturbances (20% vs 40%, P < .001); and anxieties and phobias (15% vs 44%, P < .001). Incidence of favorable discharge was lower in the men (58% vs 77%, P = .001). Even after matching for age, sociodemographic factors, and physical and cognitive functions, the differences in these symptoms persisted, with the exception of diurnal rhythm disturbances. Incidence of favorable discharge was lower in the men (60% vs 77%, P = .0173).

Conclusion: 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.

J Clin Psychiatry 2012;73(12):1548–1554

Submitted: December 21, 2011; accepted September 25, 2012(doi:10.4088/JCP.11m07614).

Corresponding author: Tatsuru Kitamura, MD, PhD, Department of Neuropsychiatry, Ishikawa Prefectural Takamatsu Hospital, Ya-36, Uchi-Takamatsu, Kahoku-City, Ishikawa, Japan, 929-1293 (matukaze@pure.ocn.ne.jp).