Sex Differences in Neuropsychiatric Symptoms of Alzheimer's Disease: The Modifying Effect of Apolipoprotein E ε4 Status.

Yi Xing,Jianping Jia,Yi Tang

doi:10.1155/2015/275256

Yi Xing, Jianping Jia + Show 1 more

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https://doi.org/10.1155/2015/275256

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Journal: Behavioural neurology	Publication Date: Jan 1, 2015
Citations: 58	License type: CC BY 3.0

Affiliation: Capital Medical University

Abstract

Sex differences in neuropsychiatric symptoms of Alzheimer's disease (AD) have been demonstrated in previous studies, and apolipoprotein E (ApoE) ε4 status influences psychiatric manifestations of AD. However, whether ApoE ε4 status modifies the sex differences in neuropsychiatric symptoms of AD is still unclear. In this study, sex differences in neuropsychiatric abnormalities were stratified and analyzed by ApoE ε4 status in mild AD and moderate to severe AD separately. The Clinical Dementia Rating (CDR) scale and the Neuropsychiatric Inventory (NPI) were used to assess dementia severity and neuropsychiatric symptoms. No sex differences were found in mild AD. In moderate to severe AD, among ε4 positive individuals, disinhibition was significantly more prevalent (8.0% in men versus 43.2% in women, p = 0.003) and severer (p = 0.003) in female patients. The frequency (16.0% in men versus 51.4% in women, p = 0.005) and score (p = 0.004) of irritability were of borderline significance after strict Bonferroni correction. In conclusion, this study supported the modifying effect of ApoE ε4 status on sex differences in neuropsychiatric symptoms of AD, and this modifying effect was pronounced in moderate to severe stage of AD. The interaction between gender and ApoE ε4 status should be considered in studies on neuropsychiatric symptoms of AD.

Highlights

Alzheimer’s disease (AD), as the most common dementia and the major cause for senile dementia, is usually characterized by cognitive impairments, neuropsychiatric symptoms affect most of patients with AD [1]
We investigated the interactions between gender and Apolipoprotein E (ApoE) ε4 status in neuropsychiatric symptoms of AD
All subjects were selected from consecutive patients diagnosed with AD in the baseline stage of China Cognition and Aging Study (China COAST), which is a national study on the mild cognitive impairment (MCI) and dementia based on hospital population [14, 15]

Summary

Introduction

Alzheimer’s disease (AD), as the most common dementia and the major cause for senile dementia, is usually characterized by cognitive impairments, neuropsychiatric symptoms affect most of patients with AD [1]. Sex difference is a common phenomenon in AD and manifests in many ways, and some previous studies had suggested sex-specific neuropsychiatric symptoms in AD. The associations between ApoE genotype and delusion, aggression, anxiety, apathy, and depression symptoms of AD have been reported [10,11,12]. Our previous study suggested that ApoE ε4 status regulated the effects of sex hormones on neuropsychiatric symptoms of AD in female patients but not in males [14]. We inferred that ApoE ε4 status influences sex differences in neuropsychiatric symptoms of AD.

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