Gender differences in the treatment of behavior problems in Alzheimer's disease

Objective: To define gender differences in noncognitive behavioral problems of patients with AD and differences in the associated treatment of those p roblems. Design/Methods: We performed an observational study using the Syst ematic Assessment and Geriatric drug use via Epidemiology (SAGE) database, which contains data collected with the Minimum Data Set on a cross-section of nursing home residents in five US states. Behavior problems were documen ted at the first assessment of 28,367 residents with AD. We evaluated the r ole of gender differences in behavior as predictors of differences in nonph armacologic versus specific pharmacologic therapies with psychoactive medic ations using logistic regression. Results: Men were more likely than women to exhibit behavior problems such as wandering, abusiveness, and social imp ropriety (59% versus 50% for any behavior problem). Hallucinations and delu sions as well as depression were equally prevalent in men and women. Nevert heless, men were more likely to receive psychoactive medications. Among the specific drug categories examined, and controlling for age and degree of c ognitive impairment, men were more likely to receive antipsychotic drugs an d less likely to be receiving antidepressants. Conclusion: Gender appears t o play an important role in determining the frequency of behavioral problem s in nursing home residents with AD, which may influence choice of treatmen ts as well as the decision whether to treat. The use of more potent tranqui lizers in men with problem behaviors has potential implications for morbidi ty, deserving further investigation.