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Neuropsychiatric symptoms in patients with possible vascular cognitive impairment, does sex matter?

BACKGROUND: Neuropsychiatric symptoms (NPS) are common in patients with vascular cognitive impairment (VCI). We aimed to establish sex differences in the manifestation of NPS in memory clinic patients with possible VCI and identify which NPS are determinants of clinical progression in women and men...

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Autores principales: Exalto, LG, Boomsma, JM, Sep, YCP, Leeuwis, AE, Scheltens, P, Biessels, GJ, van der Flier, WM
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9616441/
https://www.ncbi.nlm.nih.gov/pubmed/36324391
http://dx.doi.org/10.1016/j.cccb.2022.100152
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author Exalto, LG
Boomsma, JM
Sep, YCP
Leeuwis, AE
Scheltens, P
Biessels, GJ
van der Flier, WM
author_facet Exalto, LG
Boomsma, JM
Sep, YCP
Leeuwis, AE
Scheltens, P
Biessels, GJ
van der Flier, WM
author_sort Exalto, LG
collection PubMed
description BACKGROUND: Neuropsychiatric symptoms (NPS) are common in patients with vascular cognitive impairment (VCI). We aimed to establish sex differences in the manifestation of NPS in memory clinic patients with possible VCI and identify which NPS are determinants of clinical progression in women and men separately. METHODS: We included 718 memory clinic patients (age 68 ± 8; 45% women) with cognitive complaints and vascular brain lesions on MRI (i.e. possible VCI). NPS were measured using the 12-item Neuropsychiatric Inventory. Clinical progression after two years (women 18%, men 14%) was defined as increase in CDR ≥1 or institutionalization (available n = 589 without advanced dementia at baseline). The association between NPS and clinical progression was assessed with Cox proportional hazard models stratified by sex, adjusted for age and clinical diagnosis and in a second model additionally for manifestations of vascular brain lesions. RESULTS: Men more often presented with agitation (29% versus 17%, p<.05) and irritability (58% versus 45%, p<.05), the other 10 NPS (delusions, hallucinations, depression, anxiety, euphoria, apathy, disinhibition, aberrant motor behavior, nighttime disturbances and appetite & eating abnormalities) did not differ between sexes. In women the presence of apathy (HR 2.1[1.1;4.3]) was associated with higher risk of clinical progression. In men the presence of depression (HR 2.7[1.4;5.1]) and aberrant motor behavior (HR 2.1[1.1;3.8]) were associated with increased risk of clinical progression. CONCLUSION: Manifestations of NPS in patients with possible VCI differ by sex. Different NPS are associated with future clinical progression in men and women. Management strategies of NPS could benefit from sex-specific approaches.
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spelling pubmed-96164412022-11-01 Neuropsychiatric symptoms in patients with possible vascular cognitive impairment, does sex matter? Exalto, LG Boomsma, JM Sep, YCP Leeuwis, AE Scheltens, P Biessels, GJ van der Flier, WM Cereb Circ Cogn Behav Article BACKGROUND: Neuropsychiatric symptoms (NPS) are common in patients with vascular cognitive impairment (VCI). We aimed to establish sex differences in the manifestation of NPS in memory clinic patients with possible VCI and identify which NPS are determinants of clinical progression in women and men separately. METHODS: We included 718 memory clinic patients (age 68 ± 8; 45% women) with cognitive complaints and vascular brain lesions on MRI (i.e. possible VCI). NPS were measured using the 12-item Neuropsychiatric Inventory. Clinical progression after two years (women 18%, men 14%) was defined as increase in CDR ≥1 or institutionalization (available n = 589 without advanced dementia at baseline). The association between NPS and clinical progression was assessed with Cox proportional hazard models stratified by sex, adjusted for age and clinical diagnosis and in a second model additionally for manifestations of vascular brain lesions. RESULTS: Men more often presented with agitation (29% versus 17%, p<.05) and irritability (58% versus 45%, p<.05), the other 10 NPS (delusions, hallucinations, depression, anxiety, euphoria, apathy, disinhibition, aberrant motor behavior, nighttime disturbances and appetite & eating abnormalities) did not differ between sexes. In women the presence of apathy (HR 2.1[1.1;4.3]) was associated with higher risk of clinical progression. In men the presence of depression (HR 2.7[1.4;5.1]) and aberrant motor behavior (HR 2.1[1.1;3.8]) were associated with increased risk of clinical progression. CONCLUSION: Manifestations of NPS in patients with possible VCI differ by sex. Different NPS are associated with future clinical progression in men and women. Management strategies of NPS could benefit from sex-specific approaches. Elsevier 2022-10-03 /pmc/articles/PMC9616441/ /pubmed/36324391 http://dx.doi.org/10.1016/j.cccb.2022.100152 Text en © 2022 The Authors. Published by Elsevier B.V. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Article
Exalto, LG
Boomsma, JM
Sep, YCP
Leeuwis, AE
Scheltens, P
Biessels, GJ
van der Flier, WM
Neuropsychiatric symptoms in patients with possible vascular cognitive impairment, does sex matter?
title Neuropsychiatric symptoms in patients with possible vascular cognitive impairment, does sex matter?
title_full Neuropsychiatric symptoms in patients with possible vascular cognitive impairment, does sex matter?
title_fullStr Neuropsychiatric symptoms in patients with possible vascular cognitive impairment, does sex matter?
title_full_unstemmed Neuropsychiatric symptoms in patients with possible vascular cognitive impairment, does sex matter?
title_short Neuropsychiatric symptoms in patients with possible vascular cognitive impairment, does sex matter?
title_sort neuropsychiatric symptoms in patients with possible vascular cognitive impairment, does sex matter?
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9616441/
https://www.ncbi.nlm.nih.gov/pubmed/36324391
http://dx.doi.org/10.1016/j.cccb.2022.100152
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