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Sex Differences in Cognitive Decline Among US Adults.
Wednesday,2021-04-21 16:33 America/Los_Angeles — ecterry
| Title | Sex Differences in Cognitive Decline Among US Adults. |
| Publication Type | Journal Article |
| Year of Publication | 2021 |
| Authors | Levine, DA, Gross, AL, Briceño, EM, Tilton, N, Giordani, BJ, Sussman, JB, Hayward, RA, Burke, JF, Hingtgen, S, Elkind, MSV, Manly, JJ, Gottesman, RF, Gaskin, DJ, Sidney, S, Sacco, RL, Tom, SE, Wright, CB, Yaffe, K, Galecki, AT |
| Journal | JAMA Netw Open |
| Volume | 4 |
| Issue | 2 |
| Pagination | e210169 |
| Date Published | 2021 02 01 |
| ISSN | 2574-3805 |
| Keywords | Aged, Cognitive Dysfunction, Cognitive Reserve, Cohort Studies, Executive Function, Humans, Memory, Middle Aged, Risk, Sex Factors, Time Factors, United States |
| Abstract | <p><b>Importance: </b>Sex differences in dementia risk are unclear, but some studies have found greater risk for women.</p><p><b>Objective: </b>To determine associations between sex and cognitive decline in order to better understand sex differences in dementia risk.</p><p><b>Design, Setting, and Participants: </b>This cohort study used pooled analysis of individual participant data from 5 cohort studies for years 1971 to 2017: Atherosclerosis Risk in Communities Study, Coronary Artery Risk Development in Young Adults Study, Cardiovascular Health Study, Framingham Offspring Study, and Northern Manhattan Study. Linear mixed-effects models were used to estimate changes in each continuous cognitive outcome over time by sex. Data analysis was completed from March 2019 to October 2020.</p><p><b>Exposure: </b>Sex.</p><p><b>Main Outcomes and Measures: </b>The primary outcome was change in global cognition. Secondary outcomes were change in memory and executive function. Outcomes were standardized as t scores (mean [SD], 50 [10]); a 1-point difference represents a 0.1-SD difference in cognition.</p><p><b>Results: </b>Among 34 349 participants, 26 088 who self-reported Black or White race, were free of stroke and dementia, and had covariate data at or before the first cognitive assessment were included for analysis. Median (interquartile range) follow-up was 7.9 (5.3-20.5) years. There were 11 775 (44.7%) men (median [interquartile range] age, 58 [51-66] years at first cognitive assessment; 2229 [18.9%] Black) and 14 313 women (median [interquartile range] age, 58 [51-67] years at first cognitive assessment; 3636 [25.4%] Black). Women had significantly higher baseline performance than men in global cognition (2.20 points higher; 95% CI, 2.04 to 2.35 points; P < .001), executive function (2.13 points higher; 95% CI, 1.98 to 2.29 points; P < .001), and memory (1.89 points higher; 95% CI, 1.72 to 2.06 points; P < .001). Compared with men, women had significantly faster declines in global cognition (-0.07 points/y faster; 95% CI, -0.08 to -0.05 points/y; P < .001) and executive function (-0.06 points/y faster; 95% CI, -0.07 to -0.05 points/y; P < .001). Men and women had similar declines in memory (-0.004 points/y faster; 95% CI, -0.023 to 0.014; P = .61).</p><p><b>Conclusions and Relevance: </b>The results of this cohort study suggest that women may have greater cognitive reserve but faster cognitive decline than men, which could contribute to sex differences in late-life dementia.</p> |
| DOI | 10.1001/jamanetworkopen.2021.0169 |
| Alternate Journal | JAMA Netw Open |
| PubMed ID | 33630089 |
| PubMed Central ID | PMC7907956 |
| Grant List | R01 AG051827 / AG / NIA NIH HHS / United States P30 AG053760 / AG / NIA NIH HHS / United States K01 AG050699 / AG / NIA NIH HHS / United States K01 AG050723 / AG / NIA NIH HHS / United States R01 AG063887 / AG / NIA NIH HHS / United States R01 NS102715 / NS / NINDS NIH HHS / United States P30 AG024824 / AG / NIA NIH HHS / United States |
ePub date:
21/03