Gender differences in the treatment of behavior problems in Alzheimer's disease. SAGE Study Group. Systemic Assessment of Geriatric drug use via Epidemiology.
OBJECTIVE
To define gender differences in noncognitive behavioral problems of patients with AD and differences in the associated treatment of those problems.


METHODS
We performed an observational study using the Systematic Assessment and Geriatric drug use via Epidemiology (SAGE) database, which contains data collected with the Minimum Data Set on a cross-section of nursing home residents in five US states. Behavior problems were documented at the first assessment of 28,367 residents with AD. We evaluated the role of gender differences in behavior as predictors of differences in nonpharmacologic versus specific pharmacologic therapies with psychoactive medications using logistic regression.


RESULTS
Men were more likely than women to exhibit behavior problems such as wandering, abusiveness, and social impropriety (59% versus 50% for any behavior problem). Hallucinations and delusions as well as depression were equally prevalent in men and women. Nevertheless, men were more likely to receive psychoactive medications. Among the specific drug categories examined, and controlling for age and degree of cognitive impairment, men were more likely to receive antipsychotic drugs and less likely to be receiving antidepressants.


CONCLUSIONS
Gender appears to play an important role in determining the frequency of behavioral problems in nursing home residents with AD, which may influence choice of treatments as well as the decision whether to treat. The use of more potent tranquilizers in men with problem behaviors has potential implications for morbidity, deserving further investigation.
Ott
B R
BR
Department of Clinical Neurosciences Center for Gerontology and Health Care Research, Brown University, Providence, RI, USA.
Lapane
K L
KL
Gambassi
G
G
D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000188:drug therapy* / Q000523:psychology*; D000928:Antidepressive Agents / Q000008:administration & dosage; D014150:Antipsychotic Agents / Q000008:administration & dosage; D003072:Cognition Disorders / Q000188:drug therapy / Q000523:psychology; D003221:Confusion / Q000188:drug therapy / Q000523:psychology; D005260:Female; D006212:Hallucinations / Q000188:drug therapy / Q000523:psychology; D006801:Humans; D008297:Male; D009735:Nursing Homes; D010818:Practice Patterns, Physicians'; D012737:Sex Factors; D014754:Violence
D000928:Antidepressive Agents; D014150:Antipsychotic Agents