Gender differences in the frequency and treatment of behavior problems in Parkinson's disease. SAGE Study Group. Systematic Assessment and Geriatric drug use via Epidemiology.
OBJECTIVE
To determine gender differences in the prevalence, survival rates, and management of noncognitive behavioral problems of patients with Parkinson's disease (PD) in nursing homes (NH).


METHODS
We performed an observational study on 24,402 residents with PD using the Systematic Assessment and Geriatric drug use via Epidemiology (SAGE) database collected from the Minimum Data Set on a cross-section of over 400,000 NH residents in five US states. Gender differences in behavior were used to predict differences in pharmacologic and nonpharmacologic therapies using logistic regression. Similar analyses were done to evaluate gender differences in 1-year survival rates among patients with PD with and without behavioral problems.


RESULTS
36% of men and 33% of women exhibited behavioral problems. Wandering, verbal and physical abusiveness, and inappropriate behavior tended to be more common in men, especially among PD residents with severe cognitive impairment. Hallucinations and delusions were equally prevalent between genders and depressive symptoms were more common in women. Regardless of behavioral manifestation, men were more likely to receive antipsychotic drugs, whereas women were more likely to receive antidepressants. This gender difference in treatment was also widest among the severely demented group. Although women lived longer, no difference in survival curves were noted between PD residents with and without behavioral problems.


CONCLUSIONS
Gender appears to play an important role in determining the frequency and treatment of behavioral problems of NH residents with PD.
Fernandez
H H
HH
Department of Clinical Neurosciences, Brown University, Providence, Rhode Island, USA.
Lapane
K L
KL
Ott
B R
BR
Friedman
J H
JH
D000203:Activities of Daily Living / Q000145:classification; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D003704:Dementia / Q000401:mortality / Q000628:therapy*; D005260:Female; D006707:Homes for the Aged; D006801:Humans; D008134:Long-Term Care; D008297:Male; D009483:Neuropsychological Tests; D009735:Nursing Homes; D010300:Parkinson Disease / Q000401:mortality / Q000628:therapy*; D012737:Sex Factors; D012920:Social Behavior Disorders / Q000401:mortality / Q000628:therapy*; D015996:Survival Rate