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Association of sex differences in dementia risk factors with sex differences in memory decline in a population-based cohort spanning 20-76 years.

ABSTRACT: Sex differences in late-life memory decline may be explained by sex differences in dementia risk factors. Episodic memory and dementia risk factors were assessed in young, middle-aged and older adults over 12 years in a population-based sample (N = 7485). For men in midlife and old age, physical, cognitive and social activities were associated with less memory decline, and financial hardship was associated with more. APOE e4 and vascular risk factors were associated with memory decline for women in midlife. Depression, cognitive and physical activity were associated with memory change in older women. Incident midlife hypertension (β = - 0.48, 95% CI - 0.87, - 0.09, p = 0.02) was associated with greater memory decline in women and incident late-life stroke accounted for greater memory decline in men (β = - 0.56, 95% CI - 1.12, - 0.01), p = 0.05). Women have fewer modifiable risk factors than men. Stroke and hypertension explained sex differences in memory decline for men and women respectively.

SUBMITTER: Anstey KJ

PROVIDER: S-EPMC8032756 | biostudies-literature | 2021 Apr

REPOSITORIES: biostudies-literature

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Association of sex differences in dementia risk factors with sex differences in memory decline in a population-based cohort spanning 20-76 years.

Anstey Kaarin J KJ Peters Ruth R Mortby Moyra E ME Kiely Kim M KM Eramudugolla Ranmalee R Cherbuin Nicolas N Huque Md Hamidul MH Dixon Roger A RA

Scientific reports 20210408 1

Sex differences in late-life memory decline may be explained by sex differences in dementia risk factors. Episodic memory and dementia risk factors were assessed in young, middle-aged and older adults over 12 years in a population-based sample (N = 7485). For men in midlife and old age, physical, cognitive and social activities were associated with less memory decline, and financial hardship was associated with more. APOE e4 and vascular risk factors were associated with memory decline for women ...[more]

PMID: 33833259

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Project description:BackgroundExtracurricular sport participation and exercise (ESPE) refers to regular exercise/sport participation in addition to the physical education in school among a school-aged population. Rather than general physical activity, ESPE is typically deliberately initiated and presents an efficient target for interventions. However, compared to physical activity, relatively few studies have investigated sex differences in the development of and factors associated with ESPE using a person-centered approach. This study aimed to examine the latent trajectories of ESPE from childhood to emerging adulthood across sexes, and to identify the associated sex-specific individual (i.e., body mass index, body dissatisfaction, stress, and screen behavior) and parental (i.e., parental exercise and parental screen behavior) factors.MethodsThis study used data from part of the Child and Adolescent Behavior in Long-term Evolution (CABLE) project, which comprised 2072 fourth graders (aged 9 years) in Northern Taiwan followed annually from 2001 to 2013 (13 waves). Repeated-measures latent class analysis was used to identify the trajectories of ESPE for males and females, respectively. Multinomial logistic regression was further used to identify sex-specific factors related to ESPE.ResultsFour trajectories of ESPE were identified for males and females. For males, these trajectories were Rarely-to-Never (20%), Often-to-Rarely (32%), Always-to-Never (21%), and Always (27%). For females, these trajectories were Rarely-to-Never (34%), Rarely (23%), Always-to-Rarely (33%), and Always (10%). We observed that the developmental patterns of ESPE varied by sex such that there was an earlier decline in the trajectories of ESPE in females than in males and that, compared with males, fewer females maintained exercise habits in young adulthood. Furthermore, we found several sex-specific factors related to ESPE, namely, stress, BMI, and parental exercise. Body dissatisfaction and individual screen behavior were associated with trajectories of ESPE for both sexes.ConclusionsWe found distinct trajectories of ESPE from childhood to emerging adulthood for both sexes. The trajectories of ESPE for males and females, however, differ in terms of patterns and associated factors. Our findings suggest that efforts to increase ESPE should be initiated early, and may be made more effective by considering sex differences.

Project description:The current longitudinal study examined factors (sex, physical function, response to novelty, ability to adapt to a shift in light/dark cycle, brain connectivity), which might predict the emergence of impaired memory during aging. Male and female Fisher 344 rats were tested at 6, 12, and 18 months of age. Impaired spatial memory developed in middle-age (12 months), particularly in males, and the propensity for impairment increased with advanced age. A reduced response to novelty was observed over the course of aging, which is inconsistent with cross-sectional studies. This divergence likely resulted from differences in the history of environmental enrichment/impoverishment for cross-sectional and longitudinal studies. Animals that exhibited lower level exploration of the inner region on the open field test exhibited better memory at 12 months. Furthermore, males that exhibited a longer latency to enter a novel environment at 6 months, exhibited better memory at 12 months. For females, memory at 12 months was correlated with the ability to behaviorally adapt to a shift in light/dark cycle. Functional magnetic resonance imaging of the brain, conducted at 12 months, indicated that the decline in memory was associated with altered functional connectivity within different memory systems, most notably between the hippocampus and multiple regions such as the retrosplenial cortex, thalamus, striatum, and amygdala. Overall, some factors, specifically response to novelty at an early age and the capacity to adapt to shifts in light cycle, predicted spatial memory in middle-age, and spatial memory is associated with corresponding changes in brain connectivity. We discuss similarities and differences related to previous longitudinal and cross-sectional studies, as well as the role of sex differences in providing a theoretical framework to guide future longitudinal research on the trajectory of cognitive decline. In addition to demonstrating the power of longitudinal studies, these data highlight the importance of middle-age for identifying potential predictive indicators of sexual dimorphism in the trajectory in brain and cognitive aging.

Project description:ImportanceChronic pain is common among the elderly and is associated with cognitive deficits in cross-sectional studies; the population-level association between chronic pain and longitudinal cognition is unknown.ObjectiveTo determine the population-level association between persistent pain, which may reflect chronic pain, and subsequent cognitive decline.Design, setting, and participantsCohort study with biennial interviews of 10 065 community-dwelling older adults in the nationally representative Health and Retirement Study who were 62 years or older in 2000 and answered pain and cognition questions in both 1998 and 2000. Data analysis was conducted between June 24 and October 31, 2016.Exposures"Persistent pain," defined as a participant reporting that he or she was often troubled with moderate or severe pain in both the 1998 and 2000 interviews.Main outcomes and measuresCoprimary outcomes were composite memory score and dementia probability, estimated by combining neuropsychological test results and informant and proxy interviews, which were tracked from 2000 through 2012. Linear mixed-effects models, with random slope and intercept for each participant, were used to estimate the association of persistent pain with slope of the subsequent cognitive trajectory, adjusting for demographic characteristics and comorbidities measures in 2000 and applying sampling weights to represent the 2000 US population. We hypothesized that persistent pain would predict accelerated memory decline and increased probability of dementia. To quantify the impact of persistent pain on functional independence, we combined our primary results with information on the association between memory and ability to manage medications and finances independently.ResultsOf the 10 065 eligible HRS sample members, 60% were female, and median baseline age was 73 years (interquartile range, 67-78 years). At baseline, persistent pain affected 10.9% of participants and was associated with worse depressive symptoms and more limitations in activities of daily living. After covariate adjustment, persistent pain was associated with 9.2% (95% CI, 2.8%-15.0%) more rapid memory decline compared with those without persistent pain. After 10 years, this accelerated memory decline implied a 15.9% higher relative risk of inability to manage medications and an 11.8% higher relative risk of inability to manage finances independently. Adjusted dementia probability increased 7.7% faster (95% CI, 0.55%-14.2%); after 10 years, this translates to an absolute 2.2% increase in dementia probability for those with persistent pain.Conclusions and relevancePersistent pain was associated with accelerated memory decline and increased probability of dementia.

Dataset Information

Association of sex differences in dementia risk factors with sex differences in memory decline in a population-based cohort spanning 20-76 years.

Publications

Association of sex differences in dementia risk factors with sex differences in memory decline in a population-based cohort spanning 20-76 years.

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