AUTHOR=Stanley Madison , Poupore Nicolas , Knisely Krista , Miller Alyssa , Imeh-Nathaniel Adebobola , Roley Laurie Theriot , Imeh-Nathaniel Samuel , Goodwin Rich , Nathaniel Thomas I. 

TITLE=Differences in pharmacologic and demographic factors in male and female patients with vascular dementia, Alzheimer's disease, and mixed vascular dementia

JOURNAL=Frontiers in Dementia

VOLUME=Volume 2 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/dementia/articles/10.3389/frdem.2023.1137856

DOI=10.3389/frdem.2023.1137856

ISSN=2813-3919

ABSTRACT=Background. Increasing evidence suggests that demographic and pharmacologic factors may play a significant role in the epidemiology dementia. Sex differences in prevalence also depend on dementia subtypes, such as Alzheimer dementia (AD), vascular dementia (VaD), and mixed vascular-Alzheimer dementia (MVAD). Therefore, studies are needed to investigate sex-specific differences, and identify potential therapeutic targets for both sexes. 
Methods. Data was collected from the Prisma Health-Upstate Alzheimer registry from 2016 to 2021 for 6,039 VaD patients, 9,290 AD patients, and 412 MVAD patients. A logistic regression was used to determine demographic and pharmacological factors associated with gender differences in patients with VaD, AD, and MVAD.
Results. In patients with VaD, African Americans(OR = 1.454, 95% CI, 1.257-1.682, p<0.001)  with increasing age (OR = 1.023, 95% CI, 1.017-1.029, p<0.001), treated with  aripiprazole (OR = 4.395, 95% CI, 2.880-6.707, p<0.001),  were associated with females, whereas patients treated with  galantamine (OR = 0.228, 95% CI, 0.116-0.449, p<0.001), memantine (OR = 0.662, 95% CI, 0.590-0.744, p<0.001), with a history of tobacco (OR = 0.312, 95% CI, 0.278-0.349, p<0.001), and ETOH (OR = 0.520, 95% CI, 0.452-0.598, p<0.001) were associated with males. Among AD patients, African Americans (OR = 1.747, 95% CI, 1.486-2.053, p<0.001), and Hispanics (OR = 3.668, 95% CI, 1.198-11.231, P=0.023) were associated with females, whereas patients treated with  memantine (OR = 0.882, 95% CI, 0.799-0.974, p=0.013), and with a history of  tobacco (OR = 0.247, 95% CI, 0.224-0.273, p<0.001), and ETOH (OR = 0.627, 95% CI, 0.547-0.718, p<0.001) were associated with male AD patients. In patients with MVAD, rivastigmine (OR = 3.293, 95% CI, 1.131-9.585, p=0.029), memantine (OR = 2.816, 95% CI, 1.534-5.168, p<0.001), and risperidone (OR = 10.515, 95% CI, 3.409-32.437, p<0.001), were associated with females while ETOH use (OR = 0.229, 95% CI, 0.110-0.477, p<0.001) were more likely to be associated with males.
Conclusions. Our study revealed gender differences and similarities in the demographic and pharmacological factors of VaD, AD, and MVAD. Prospective studies are needed to determine the role of demographic and pharmacological factors in reducing sex-based disparities among VaD, AD, and MVAD patients..