ArticleFrontiers in psychiatry2026
Uncovering sex patterns in BPSD among home-care patients: longitudinal findings from a population-based registry - digital dementia registry Bavaria.
Article in Frontiers in psychiatry, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Behavioral and psychological symptoms of dementia (BPSD) are core features of Alzheimer's disease and related dementias. Previous research suggests possible sex differences in the prevalence and severity of BPSD; however, findings remain inconsistent. Moreover, most existing studies are cross-sectional and focus on institutionalized populations, while evidence from home-dwelling individuals is highly limited. As many people with dementia live at home for a substantial part of the disease trajectory, longitudinal analyses in this setting are essential. Methods: This study used data from the population-based, prospective Digital Dementia Registry Bavaria (digiDEM Bayern). A total of 368 home-dwelling individuals with mild cognitive impairment or mild to moderate dementia were included. BPSD were assessed at baseline and after 12 months using the Neuropsychiatric Inventory (NPI). Sex differences over time were examined using a mixed ANOVA, with age, educational level, and dementia severity included as covariates. Results: Overall, NPI scores showed a descriptive increase over the 12-month follow-up period. Men showed higher mean NPI scores than women at both measurement points. In unadjusted analyses, a significant main effect of time and a between-subjects effect of sex were observed. However, no significant interaction between sex and time was found. After adjusting for age, education, and dementia severity, neither time effects nor sex differences remained statistically significant. Conclusion: The findings suggest that sex differences in BPSD among home-dwelling individuals with dementia are not explained by sex alone. BPSD may be largely influenced by underlying demographic and clinical factors such as age, educational level, and dementia severity. This study highlights the importance of considering these covariates when examining BPSD and underscores the value of longitudinal, population-based research in home-care settings to better inform future dementia care strategies.
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