ORIGINAL RESEARCH article
Front. Dement.
Sec. Aging and Risk Factors for Dementia
Volume 4 - 2025 | doi: 10.3389/frdem.2025.1593788
This article is part of the Research TopicInsights in Dementia: 2024View all 7 articles
Sex Differences in Risk Factors for Alzheimer Dementia Encephalopathy Patients
Provisionally accepted
John Connor O’brien1
Wayne James Patterson1Taiwo Dami Ojo1
Gerhard Nathan Faulstich1
Joseph Killian Bucci1Cole Philip Brewer1
Adebobola Imeh-Nathaniel2Emmanuel I Nathaniel2
Laurie Theriot Roley3
Rich Goodwin4
Thomas I Nathaniel1*- 1School of Medicine Greenville, University of South Carolina, Greenville, South Carolina, United States
- 2North Greenville University, Tigerville, South Carolina, United States
- 3Prisma Health, Greer, South Carolina, United States
- 4University of South Carolina, Columbia, Missouri, United States
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Background. The objective is to identify risk factors that contribute to sex differences in Alzheimer dementia (AD) patients with encephalopathy (ADEN) and determine whether these factors are different between male and female ADEN patients. This is the first largescale study comparing sex-specific ADEN risk profiles.Our retrospective cohort study analyzed data collected from February 2016 to August 2020. It included a total of 128,769 AD patients, among whom 41,266 AD patients also presented with encephalopathy, compared to 87,503 AD patients that did not. The univariate analysis was used to determine differences in risk factors for male and female AD patients. Multivariate analysis predicted specific risk factors associated with male and female ADEN patients.Result: In the adjusted analysis, males presented with hypertension (OR = 1.144, 95% CI, 1.094 -1.197, p < 0.001), peripheral vascular disease (OR = 1.606, 95% CI, 1.485 -1.737, p < 0.001), atrial fibrillation (OR = 1.555, 95% CI, 1.443 -1.676, p < 0.001), hallucinations (OR = 1.406, 95% CI, 1.119 -1.766, p = 0.003), and traumatic head injury (OR = 3.211, 95% CI, 2.346 -4.395, p < 0.001). Females presented with osteoporosis (OR = 0.307, 95% CI, 0.278 -0.340, p < 0.001), unspecified cancer (OR = 0.615, 95% CI, 0.512 -0.740, p < 0.001), anxiety (OR = 0.609, 95% CI, 0.565 -0.655, p < 0.001), urinary tract infections (UTI) (OR = 0.451, 95% CI, 0.423 -0.481, p < 0.001), upper respiratory infections (URI) (OR = 0.531, 95% CI, 0.432 -0.653, p < 0.001) and gastrointestinal ulceration (OR = 0.338, 95% CI, 0.269 -0.424, p < 0.001).Our analysis identified risk factors that contribute to sex differences in ADEN. This difference was fully mediated by peripheral vascular disease, atrial fibrillation, hallucinations, and traumatic head injury for males and unspecified cancer, anxiety, urinary tract infections, upper respiratory infections, and gastrointestinal ulceration for females. These findings provide valuable insights into the risk factors that can be managed to improve the care of male and female ADEN patients
Keywords: in Alzheimer's dementia, encephalopathy, Risk factors, Sex, Male and female patients
Received: 14 Mar 2025; Accepted: 06 May 2025.
Copyright: © 2025 O’brien, Patterson, Ojo, Faulstich, Bucci, Brewer, Imeh-Nathaniel, Nathaniel, Theriot Roley, Goodwin and Nathaniel. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Thomas I Nathaniel, School of Medicine Greenville, University of South Carolina, Greenville, SC 29605, South Carolina, United States
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.