title: Apolipoprotein E ε4 status modifies the effects of sex hormones on neuropsychiatric symptoms of Alzheimer's disease.
abstract: BACKGROUND
  Studies on the associations between sex hormones and multiple neuropsychiatric symptoms of Alzheimer's disease (AD) are lacking. Apolipoprotein E (APOE) ε4 status may modify the effects of sex hormones on neuropsychiatric symptoms.
  
  
  METHODS
  A total of 86 male and 87 female AD patients participated in the present study. The adjusted associations between symptoms on the Neuropsychiatric Inventory and serum levels of estradiol (total, bioavailable) and testosterone (total, bioavailable) were analyzed.
  
  
  RESULTS
  Agitation/aggression was negatively associated with quartiles of bioavailable estradiol among male patients, and positively associated with testosterone levels among female patients. The modifying effects of APOE genotype only existed in female patients. Those females with higher levels of estradiol and the ε4 allele had higher odds of agitation/aggression. Furthermore, the testosterone × APOE ε4 status interaction was positively associated with hallucinations in female patients.
  
  
  CONCLUSIONS
  There were sex-specific effects of sex hormones on agitation/aggression in AD. Sex hormones and APOE ε4 status synergistically influence some neuropsychiatric symptoms among female but not male AD patients.
authors.affiliation: Department of Neurology, Xuan Wu Hospital of the Capital Medical University, Beijing, PR China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Xing
authors.forename: Wei
authors.initials: W
authors.lastname: Qin
authors.forename: Fang
authors.initials: F
authors.lastname: Li
authors.forename: Xiang-Fei
authors.initials: XF
authors.lastname: Jia
authors.forename: Jianping
authors.initials: J
authors.lastname: Jia
mesh_terms: D000368:Aged; D000483:Alleles; D000544:Alzheimer Disease / Q000150:complications / Q000235:genetics* / Q000523:psychology*; D053327:Apolipoprotein E4 / Q000235:genetics*; D002681:China / Q000453:epidemiology; D004522:Educational Status; D004958:Estradiol / Q000097:blood; D005260:Female; D012739:Gonadal Steroid Hormones / Q000097:blood* / Q000502:physiology; D006212:Hallucinations / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D016015:Logistic Models; D008297:Male; D001523:Mental Disorders / Q000209:etiology / Q000235:genetics* / Q000523:psychology*; D011595:Psychomotor Agitation / Q000453:epidemiology / Q000209:etiology; D012307:Risk Factors; D012737:Sex Factors; D013739:Testosterone / Q000097:blood
chemical_list: D053327:Apolipoprotein E4; D012739:Gonadal Steroid Hormones; D013739:Testosterone; D004958:Estradiol