Sex Differences in Dementia

Hogervorst, Eef; Temple, Sophie; O’Donnell, Emma

doi:10.1007/7854_2022_408

Cited by 14 publications

(10 citation statements)

References 93 publications

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“…Our analysis indicated that female sex is linked to a lower risk for major NCD progression, a conclusion that draws upon a body of research exploring sex-specific influences on cognitive health. Studies [ 77 , 78 ] have consistently observed a higher prevalence and elevated risk of AD among women compared to men. These findings suggest potential sex-specific vulnerabilities to certain forms of dementia, underscoring the need to explore biological and environmental factors that may contribute to these disparities.…”

Section: Discussionmentioning

confidence: 99%

Predictive Models for the Transition from Mild Neurocognitive Disorder to Major Neurocognitive Disorder: Insights from Clinical, Demographic, and Neuropsychological Data

Tsiakiri,

Bakirtzis,

Plakias

et al. 2024

Biomedicines

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Neurocognitive disorders (NCDs) are progressive conditions that severely impact cognitive function and daily living. Understanding the transition from mild to major NCD is crucial for personalized early intervention and effective management. Predictive models incorporating demographic variables, clinical data, and scores on neuropsychological and emotional tests can significantly enhance early detection and intervention strategies in primary healthcare settings. We aimed to develop and validate predictive models for the progression from mild NCD to major NCD using demographic, clinical, and neuropsychological data from 132 participants over a two-year period. Generalized Estimating Equations were employed for data analysis. Our final model achieved an accuracy of 83.7%. A higher body mass index and alcohol drinking increased the risk of progression from mild NCD to major NCD, while female sex, higher praxis abilities, and a higher score on the Geriatric Depression Scale reduced the risk. Here, we show that integrating multiple factors—ones that can be easily examined in clinical settings—into predictive models can improve early diagnosis of major NCD. This approach could facilitate timely interventions, potentially mitigating the progression of cognitive decline and improving patient outcomes in primary healthcare settings. Further research should focus on validating these models across diverse populations and exploring their implementation in various clinical contexts.

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Section: Discussionmentioning

confidence: 99%

Predictive Models for the Transition from Mild Neurocognitive Disorder to Major Neurocognitive Disorder: Insights from Clinical, Demographic, and Neuropsychological Data

Tsiakiri,

Bakirtzis,

Plakias

et al. 2024

Biomedicines

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“…In the present study, we found no association between Lp(a) and mildly reduced eGFR in women. Considering that our population was middle-aged and older, levels of sex steroids decline significantly after menopause in women, whereas this is more gradual in men with age [ 47 ].…”

Section: Discussionmentioning

confidence: 99%

Association between serum lipoprotein(a) and mildly reduced eGFR: a cross-sectional study

Zhang,

Chen,

Xiang

et al. 2023

BMC Nephrol

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Lipoprotein(a) [Lp(a)] is a risk factor for cardiovascular disease (CVD) and aortic stenosis. However, the data on the relationship between Lp(a) and mildly reduced estimated glomerular filtration rate (eGFR) has been disputed. This study was conducted to assess the relationship between Lp(a) concentrations and mildly reduced eGFR in healthy subjects.This community-based, cross-sectional study enrolled 1,064 volunteers aged ≥ 40 years who lived in Yonghong Community, Zhonglou District, Changzhou, China, between December 2016 and December 2017. A mildly reduced eGFR was defined as eGFR between 60 and 90 mL/min/1.73m2. A standardized questionnaire and biochemical measurements were used to gather information about participants. The serum concentration of Lp(a) was determined using the latex-enhanced immunoturbidimetric test. Of the total study population, 34.8% (n = 370) were men, and the mean age was 66.8 ± 8.5 years. A significant association existed between Lp(a) levels and the risk of mildly reduced eGFR. Individuals with the highest tertile of Lp(a) had higher odds of mildly reduced eGFR after adjusting for various confounders (adjusted odds ratio [OR]: 1.80, 95% confidence interval [CI]: 1.24–2.60, P = 0.0025) compared to those with the lowest tertile of Lp(a). Multivariable logistic regression of studies in which Lp(a) was presented as continuous variables showed consistent results (adjusted OR: 1.23 for 1-SD increment of Ln-Lp(a), 95% CI: 1.05–1.43). Subgroup analyses showed that study characteristics such as age, sex, obesity, diabetes, and hypertension status did not significantly affect the association (P for all interactions > 0.05). These results suggest that higher serum Lp(a) level was an independent risk factor for mildly reduced eGFR.

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“…Yet, our study contributes to a critical area in public health, given the rising prevalence of chronic, non-communicable diseases such as cardiometabolic disease and neurodegenerative conditions (137,138). Despite known sex differences in the aetiology, prevalence, and outcomes of these diseases (139)(140)(141)(142), there remains a severe lack of research on female-specific factors and risks (143-145). While our study highlights distinct cardiometabolic patterns in pre-and postmenopausal females and relationships of these with cerebrovascular outcomes, it also underscores the critical need for detailed, longitudinal studies encompassing both midlife and older age in females.…”

Section: Associations Between Markers Of Cardiometabolic Health and W...mentioning

confidence: 99%

Cardiometabolic health across menopausal years is linked to white matter hyperintensities up to a decade later

Schindler,

Subramaniapillai,

Ambikairajah

et al. 2023

Front. Glob. Womens Health

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IntroductionThe menopause transition is associated with several cardiometabolic risk factors. Poor cardiometabolic health is further linked to microvascular brain lesions, which can be detected as white matter hyperintensities (WMHs) using T2-FLAIR magnetic resonance imaging (MRI) scans. Females show higher risk for WMHs post-menopause, but it remains unclear whether changes in cardiometabolic risk factors underlie menopause-related increase in brain pathology.MethodsIn this study, we assessed whether cross-sectional measures of cardiometabolic health, including body mass index (BMI) and waist-to-hip ratio (WHR), blood lipids, blood pressure, and long-term blood glucose (HbA1c), as well as longitudinal changes in BMI and WHR, differed according to menopausal status at baseline in 9,882 UK Biobank females (age range 40–70 years, n premenopausal = 3,529, n postmenopausal = 6,353). Furthermore, we examined whether these cardiometabolic factors were associated with WMH outcomes at the follow-up assessment, on average 8.78 years after baseline.ResultsPostmenopausal females showed higher levels of baseline blood lipids (HDL β = 0.14, p < 0.001, LDL β = 0.20, p < 0.001, triglycerides β = 0.12, p < 0.001) and HbA1c (β = 0.24, p < 0.001) compared to premenopausal women, beyond the effects of age. Over time, BMI increased more in the premenopausal compared to the postmenopausal group (β = −0.08, p < 0.001), while WHR increased to a similar extent in both groups (β = −0.03, p = 0.102). The change in WHR was however driven by increased waist circumference only in the premenopausal group. While the group level changes in BMI and WHR were in general small, these findings point to distinct anthropometric changes in pre- and postmenopausal females over time. Higher baseline measures of BMI, WHR, triglycerides, blood pressure, and HbA1c, as well as longitudinal increases in BMI and WHR, were associated with larger WMH volumes (β range = 0.03–0.13, p ≤ 0.002). HDL showed a significant inverse relationship with WMH volume (β = −0.27, p < 0.001).DiscussionOur findings emphasise the importance of monitoring cardiometabolic risk factors in females from midlife through the menopause transition and into the postmenopausal phase, to ensure improved cerebrovascular outcomes in later years.

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Sex Differences in Dementia

Cited by 14 publications

References 93 publications

Predictive Models for the Transition from Mild Neurocognitive Disorder to Major Neurocognitive Disorder: Insights from Clinical, Demographic, and Neuropsychological Data

Predictive Models for the Transition from Mild Neurocognitive Disorder to Major Neurocognitive Disorder: Insights from Clinical, Demographic, and Neuropsychological Data

Association between serum lipoprotein(a) and mildly reduced eGFR: a cross-sectional study

Cardiometabolic health across menopausal years is linked to white matter hyperintensities up to a decade later

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