Abstract
ObjectivesThe correlates of manic episodes in dementia have not been systematically studied. The primary goal of our study is to compare the sociodemographic characteristics and psychiatric comorbidities in Alzheimer’s dementia (AD) inpatients with manic episodes versus without manic episodes, and to evaluate the demographic predictors and risk factors for manic episodes in AD inpatients.MethodsWe conducted a case-control study using the Nationwide Inpatient Sample of 34,285 AD patients (age ≥60 years). Subsequently, the cases i.e., AD inpatients with a manic episode (N = 1,035) and the controls (without a manic episode, N = 1,035), were extracted using propensity-score matching based on age. The cases did not have a past psychiatric history of bipolar disorders. We used the logistic regression model to evaluate the odds ratio (OR) of association between pre-existing psychiatric comorbidities and manic episodes and evaluate the demographic predictors of manic episodes in AD inpatients.ResultsA higher proportion of AD inpatients with manic episodes were females (63.8%), whites (85.2%), and from low-income families below the 50th percentile (63%). Females were more likely to be hospitalized for manic episodes (OR 1.33; 95% CI 1.09-1.64) than males. AD inpatients with manic episodes had a higher risk of presenting with suicidal behaviors (OR 1.88; 95% CI 1.23-2.86). A significantly higher proportion of AD inpatients with manic episodes had comorbid tobacco use (5.3% vs. 3.4%) and cannabis use (1.4% vs. 0%) compared to those without manic episodes.ConclusionFemales with AD had a greater risk of being hospitalized for manic episodes. These patients have an 88% higher risk of suicidal behaviors during the manic presentation and have comorbid tobacco and cannabis use. Early diagnosis and management of manic episodes in at-risk AD patients are important to improve the quality of life (QoL) and outcomes.
Highlights
Alzheimer’s dementia (AD) is a progressive neurodegenerative disease characterized by memory loss, cognitive deficits, and behavioral changes
Females were more likely to be hospitalized for manic episodes than males
AD inpatients with manic episodes had a higher risk of presenting with suicidal behaviors
Summary
Alzheimer’s dementia (AD) is a progressive neurodegenerative disease characterized by memory loss, cognitive deficits, and behavioral changes. Up until 2020, more than 5.5 million Americans, including an estimated 5.3 million people aged 65 years and older, had AD dementia, and two-thirds of them were women. By 2021, of the 6.2 million people aged 65 and older with AD in the US, 3.8 million were women, and 2.4 million were men, and the incidence of AD and other dementias is projected to double by 2050 [2]. Older black and Hispanics are disproportionately more likely to have AD or other dementias than older white Americans. Data from the Chicago Health and Aging Project (CHAP) populationbased study of chronic health conditions indicate that 18.6% of blacks and 14% of Hispanics age 65 and older have AD compared with 10% of White older adults [3]
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