Dataset Information

Sex as a Risk Factor for Developing Cognitive Impairments in National Alzheimer's Coordinating Center Participants.

ABSTRACT:

Background

It is inconclusive on how sex affects the risk of developing mild cognitive impairment (MCI) or dementia.

Objective

To investigate how sex affects the risk of developing MCI or dementia.

Methods

A secondary data analysis was performed on data collected from participants enrolled at Alzheimer's Disease Research Centers funded by National Institute on Aging. There were two inclusion criteria: 1) participants were free of dementia at the baseline visit; 2) every participant must have at least one follow-up visit. A Cox proportional hazards model was used to investigate how sex affects the risk of developing cognitive impairments.

Results

During a follow-up period of more than 10 years, male participants had a slightly higher incidence than female participants for either MCI or dementia. Not surprisingly, a higher prevalence was observed in male than female participants for either MCI or dementia. However, male participants had a higher mortality rate than their female counterparts.

Conclusion

The male sex is associated with a higher risk for developing cognitive impairments along the aging process.

SUBMITTER: Wang G

PROVIDER: S-EPMC7902986 | biostudies-literature | 2021 Jan

REPOSITORIES: biostudies-literature

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Publications

Sex as a Risk Factor for Developing Cognitive Impairments in National Alzheimer's Coordinating Center Participants.

Wang Ge G Li Wei W

Journal of Alzheimer's disease reports 20210111 1

<h4>Background</h4>It is inconclusive on how sex affects the risk of developing mild cognitive impairment (MCI) or dementia.<h4>Objective</h4>To investigate how sex affects the risk of developing MCI or dementia.<h4>Methods</h4>A secondary data analysis was performed on data collected from participants enrolled at Alzheimer's Disease Research Centers funded by National Institute on Aging. There were two inclusion criteria: 1) participants were free of dementia at the baseline visit; 2) every par ...[more]

PMID: 33681711

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Project description:BACKGROUND:Diabetes is a risk factor for the development of cognitive impairment and possibly for accelerated progression to Alzheimer disease (AD) and other dementias, though the trajectory of cognitive decline in general and in specfic cognitive domains by diabetes is unclear. METHODS:Using the National Alzheimer's Coordinating Center's Uniform Data Det (NACC-UDS) to identify cohorts of elders with normal cognition (N = 7,663) and mild cognitive impairment (MCI, N = 4,114), we compared overall cognitive composite and domain specific sub-scores and their progression over time between diabetic and non-diabetic subjects. RESULTS:Diabetes was more common among those with MCI (14.7%) than among subjects who were cognitively normal (11.7%). In subjects who were cognitively normal, baseline cognitive composite scores, attention, and executive function sub-scores were lower in diabetics than non-diabetics (by 0.098, 0.066, and 0.015 points, respectively). Over time, cognitive composite score showed subtle worsening in non-diabetics (0.025 points every 6 months), with an additional worsening of 0.01 points every 6 months in diabetics compared to non-diabetics. In the MCI groups, baseline cognitive composite as well as attention and executive domain sub-scores were lower in diabetics than non-diabetics (by 0.078, 0.092, and 0.032 points, respectively). Over time, cognitive composite (by 0.103 points every 6 months) and all domain specific sub-scores showed subtle worsening in non-diabetics, but diabetics had significantly slower worsening than non-diabetics on both cognitive composite (by 0.028 points) and domain specific sub-scores. DISCUSSION:Among elders, diabetes may be associated with lower cognitive performance, primarily in non-memory domains. However it is not associated with continued worsening, suggesting a static deficit with minimal memory involvement. This data suggest that diabetes may contribute more to a vascular profile of cognitive impairment than a profile more typical of AD.

Project description:BACKGROUND:Longitudinal investigations are needed to improve understanding of the contributions of cerebral small vessel disease to the clinical manifestation of Alzheimer's disease, particularly in the early disease stages. This study leveraged the National Alzheimer's Coordinating Center Uniform Data Set to longitudinally examine the association between white matter hyperintensities and neuropsychological, neuropsychiatric, and functional decline among participants with normal cognition. METHODS:The sample included 465 participants from the National Alzheimer's Coordinating Center Uniform Data Set who had quantitated volume of white matter hyperintensities from fluid-attenuated inversion recovery MRI, had normal cognition at the time of their MRI, and were administered the National Alzheimer's Coordinating Center Uniform Data Set neuropsychological test battery within 1?year of study evaluation and had at least two post-MRI time points of clinical data. Neuropsychiatric status was assessed by the Geriatric Depression Scale-15 and Neuropsychiatric Inventory-Questionnaire. Clinical Dementia Rating Sum of Boxes defined functional status. For participants subsequently diagnosed with mild cognitive impairment (MCI) or dementia, their impairment must have been attributed to Alzheimer's disease (AD) to evaluate the relationships between WMH and the clinical presentation of AD. RESULTS:Of the 465 participants, 56 converted to MCI or AD dementia (average follow-up?=?5?years). Among the 465 participants, generalized estimating equations controlling for age, sex, race, education, APOE ?4, and total brain and hippocampal volume showed that higher baseline log-white matter hyperintensities predicted accelerated decline on the following neuropsychological tests in rank order of effect size: Trails B (p?<?0.01), Digit Symbol Coding (p?<?0.01), Logical Memory Immediate Recall (p?=?0.02), Trail Making A (p?<?0.01), and Semantic Fluency (p?<?0.01). White matter hyperintensities predicted increases in Clinical Dementia Rating Sum of Boxes (p?<?0.01) and Geriatric Depression Scale-15 scores (p?=?0.01). Effect sizes were comparable to total brain and hippocampal volume. White matter hyperintensities did not predict diagnostic conversion. All effects also remained after including individuals with non-AD suspected etiologies for those who converted to MCI or dementia. CONCLUSIONS:In this baseline cognitively normal sample, greater white matter hyperintensities were associated with accelerated cognitive, neuropsychiatric, and functional decline independent of traditional risk factors and MRI biomarkers for Alzheimer's disease.

Dataset Information

Sex as a Risk Factor for Developing Cognitive Impairments in National Alzheimer's Coordinating Center Participants.

Background

Objective

Methods

Results

Conclusion

Publications

Sex as a Risk Factor for Developing Cognitive Impairments in National Alzheimer's Coordinating Center Participants.

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