Sex Differences in the Psychiatric Manifestations of Alzheimer's Disease

Objective: To test the null hypothesis, ie, that there are no gender differences in psychiatric problems manifest in patients with Alzheimer's disease. Design: Survey. Setting: Patients living in the community and evaluated at Alzheimer's disease and geriatric outpatient programs. Patients: Three hundred twenty‐eight women and 186 men clinically diagnosed with Alzheimer's disease using NINCDS/ADRDA or DSM‐III‐R criteria. Measurements: Psychiatric signs and symptoms recorded following a psychiatric interview, including the Hamilton Depression Rating Scale. Results: Approximately two‐thirds of both men and women had psychiatric problems, but women had significantly more multiple symptoms. When pairs of symptoms were analyzed for independence, agitation was only significantly associated with paranoia in men, whereas in women agitation was significantly associated with most other psychiatric problems. Conclusion: The higher prevalence of multiple psychiatric problems in women may be due to many factors, including sociodemographic influences, physician bias, and/or other differences between men and women. The finding of a different pattern of association of symptoms with agitation in men and women deserves replication. 1993 The American Geriatrics Society