Hubert H Fernandez1, Kate L Lapane2,3, Brian R Ott1,3, Joseph H Friedman1,3. 1. Department of Clinical Neurosciences, Brown University, Providence, Rhode Island, U.S.A. 2. Center for Gerontology and Health Care Research, Brown University, Providence, Rhode Island, U.S.A. 3. Department of Community Health, Brown University, Providence, Rhode Island, U.S.A.
Abstract
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. CONCLUSION: Gender appears to play an important role in determining the frequency and treatment of behavioral problems of NH residents with PD.
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. CONCLUSION: Gender appears to play an important role in determining the frequency and treatment of behavioral problems of NH residents with PD.
Authors: Mei Yuan; Laura Sperry; Norika Malhado-Chang; Alexandra Duffy; Vicki Wheelock; Sarah Farias; Kevin O'Connor; John Olichney; Kiarash Shahlaie; Lin Zhang Journal: Brain Behav Date: 2017-04-14 Impact factor: 2.708
Authors: Hirotaka Iwaki; Cornelis Blauwendraat; Hampton L Leonard; Mary B Makarious; Jonggeol J Kim; Ganqiang Liu; Jodi Maple-Grødem; Jean-Christophe Corvol; Lasse Pihlstrøm; Marlies van Nimwegen; Luba Smolensky; Ninad Amondikar; Samantha J Hutten; Mark Frasier; Khanh-Dung H Nguyen; Jacqueline Rick; Shirley Eberly; Faraz Faghri; Peggy Auinger; Kirsten M Scott; Ruwani Wijeyekoon; Vivianna M Van Deerlin; Dena G Hernandez; Raphael J Gibbs; Aaron G Day-Williams; Alexis Brice; Guido Alves; Alastair J Noyce; Ole-Bjørn Tysnes; Jonathan R Evans; David P Breen; Karol Estrada; Claire E Wegel; Fabrice Danjou; David K Simon; Ole A Andreassen; Bernard Ravina; Mathias Toft; Peter Heutink; Bastiaan R Bloem; Daniel Weintraub; Roger A Barker; Caroline H Williams-Gray; Bart P van de Warrenburg; Jacobus J Van Hilten; Clemens R Scherzer; Andrew B Singleton; Mike A Nalls Journal: Mov Disord Date: 2020-10-01 Impact factor: 9.698