Dataset Information

Sex Differences in Cognitive Decline Among US Adults.

ABSTRACT:

Importance

Sex differences in dementia risk are unclear, but some studies have found greater risk for women.

Objective

To determine associations between sex and cognitive decline in order to better understand sex differences in dementia risk.

Design, setting, and participants

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.

Exposure

Sex.

Main outcomes and measures

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.

Results

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?Conclusions and relevanceThe 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.

SUBMITTER: Levine DA

PROVIDER: S-EPMC7907956 | biostudies-literature | 2021 Feb

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Sex Differences in Cognitive Decline Among US Adults.

Levine Deborah A DA Gross Alden L AL Briceño Emily M EM Tilton Nicholas N Giordani Bruno J BJ Sussman Jeremy B JB Hayward Rodney A RA Burke James F JF Hingtgen Stephanie S Elkind Mitchell S V MSV Manly Jennifer J JJ Gottesman Rebecca F RF Gaskin Darrell J DJ Sidney Stephen S Sacco Ralph L RL Tom Sarah E SE Wright Clinton B CB Yaffe Kristine K Galecki Andrzej T AT

JAMA network open 20210201 2

<h4>Importance</h4>Sex differences in dementia risk are unclear, but some studies have found greater risk for women.<h4>Objective</h4>To determine associations between sex and cognitive decline in order to better understand sex differences in dementia risk.<h4>Design, setting, and participants</h4>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 ...[more]

PMID: 33630089

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Project description:BackgroundSex differences in post-stroke cognitive decline have not been systematically evaluated in a nationally representative cohort. We use a quasi-experimental design to investigate sex differences in rate of post-stroke cognitive decline.MethodsUtilizing the event study design, we use the Health and Retirement Study (HRS) data (1996-2016) to evaluate the differences (percentage points [95% Confidence interval]) in the rate of change in cognitive function, measured using the modified version of the Telephone Interview for Cognitive Status (TICS-m) score, before and after incident stroke, and among patients with and without incident stroke. We estimated this event study model for the overall study population and separately fit the same model for male and female participants.ResultsOf 25,872 HRS participants included in our study, 14,459 (55.9%) were females with an overall mean age (SD) of 61.2 (9.3) years. Overall, 2,911 (11.3%) participants reported experiencing incident stroke. Participants with incident stroke (vs. no stroke) had lower baseline TICS-m score (15.6 vs. 16.1). Among participants with incident stroke, the mean pre-stroke TICS-m score was higher than the mean post-stroke TICS-m score (14.9 vs. 12.7). Event study revealed a significant short-term acceleration of cognitive decline for the overall population (4.2 [1.7-6.6] percentage points, p value = 0.001) and among female participants (5.0 [1.7-8.3] percentage points, p value = 0.003). We, however, found no evidence of long-term acceleration of cognitive decline after stroke. Moreover, among males, incident stroke was not associated with significant changes in rate of post-stroke cognitive decline.ConclusionFemales, in contrast to males, experience post-stroke cognitive deficits, particularly during early post-stroke period. Identifying the sex-specific stroke characteristics contributing to differences in post stroke cognitive decline may inform future strategies for reducing the burden of post-stroke cognitive impairment and dementia.

Dataset Information

Sex Differences in Cognitive Decline Among US Adults.

Importance

Objective

Design, setting, and participants

Exposure

Main outcomes and measures

Results

Publications

Sex Differences in Cognitive Decline Among US Adults.

Similar Datasets

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