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Behavioural Neurology
Volume 2015, Article ID 275256, 6 pages
Research Article

Sex Differences in Neuropsychiatric Symptoms of Alzheimer’s Disease: The Modifying Effect of Apolipoprotein E ε4 Status

Yi Xing,1 Yi Tang,1 and Jianping Jia1,2,3,4

1Department of Neurology, Xuan Wu Hospital, Capital Medical University, Beijing 100053, China
2Center of Alzheimer’s Disease, Beijing Institute for Brain Disorders, Beijing 100069, China
3Beijing Key Laboratory of Geriatric Cognitive Disorders, Beijing 100053, China
4Neurodegenerative Laboratory of Ministry of Education of the People’s Republic of China, Beijing 100053, China

Received 23 June 2015; Revised 8 September 2015; Accepted 9 September 2015

Academic Editor: Hrayr Attarian

Copyright © 2015 Yi Xing et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Sex differences in neuropsychiatric symptoms of Alzheimer’s disease (AD) have been demonstrated in previous studies, and apolipoprotein E (ApoE) ε4 status influences psychiatric manifestations of AD. However, whether ApoE ε4 status modifies the sex differences in neuropsychiatric symptoms of AD is still unclear. In this study, sex differences in neuropsychiatric abnormalities were stratified and analyzed by ApoE ε4 status in mild AD and moderate to severe AD separately. The Clinical Dementia Rating (CDR) scale and the Neuropsychiatric Inventory (NPI) were used to assess dementia severity and neuropsychiatric symptoms. No sex differences were found in mild AD. In moderate to severe AD, among ε4 positive individuals, disinhibition was significantly more prevalent (8.0% in men versus 43.2% in women, ) and severer in female patients. The frequency (16.0% in men versus 51.4% in women, ) and score of irritability were of borderline significance after strict Bonferroni correction. In conclusion, this study supported the modifying effect of ApoE ε4 status on sex differences in neuropsychiatric symptoms of AD, and this modifying effect was pronounced in moderate to severe stage of AD. The interaction between gender and ApoE ε4 status should be considered in studies on neuropsychiatric symptoms of AD.