Gender, cognitive decline, and risk of AD in older persons
Gender, cognitive decline, and risk of AD in older persons
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DOI：
10.1212/01.wnl.0000065892.67099.2a
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发表时间：
2003-06-10
期刊：
影响因子：
9.9
通讯作者：
Bennett, DA
中科院分区：
文献类型：
--
作者：
Barnes, LL;Wilson, RS;Bennett, DA
背景：横断面研究表明老年人认知功能和 AD 风险存在性别差异。然而，比较男性和女性认知功能变化和 AD 风险的纵向研究得出的结果好坏参半。作者调查了不同认知系统衰退率和患 AD 风险的性别差异。方法：参与者来自宗教团体研究，这是一项针对老年天主教修女、牧师和兄弟的衰老和 AD 的纵向临床病理学研究。纵向数据来自 577 名老年女性和 271 名老年男性，他们平均完成了 5.8 次年度评估，幸存者的随访参与率超过 95%。评估包括 21 项神经心理学测试，从中形成整体认知功能和 5 个功能域的汇总测量，以及 AD 的临床分类。结果：随机效应模型用于分析认知功能的变化，比例风险模型用于评估 AD 事件的风险。平均而言，在 8 年期间，男性和女性的所有能力均有所下降，但在控制年龄、教育程度和初始认知功能水平的分析中，年变化率没有差异。 AD 事件的风险在男性和女性之间没有差异。此外，在控制了载脂蛋白-ε4 等位基因的控制后，结果没有变化。雌激素使用持续时间与女性整体认知衰退率和视觉空间能力相关，但不影响男性和女性认知衰退的比较。结论：结果表明，老年男性和女性的认知能力下降模式和 AD 发病率相似。
Background: Cross-sectional studies suggest gender differences in cognitive function and risk of AD in older persons. However, longitudinal studies comparing change in cognitive function and risk of AD in men and women have had mixed results. The authors investigated gender differences in rate of decline for different cognitive systems and for risk of developing AD. Methods: Participants were from the Religious Orders Study, a longitudinal, clinical - pathologic study of aging and AD in older Catholic nuns, priests, and brothers. Longitudinal data were available from 577 older women and 271 older men, who completed an average of 5.8 annual evaluations with more than 95% follow-up participation in survivors. The evaluations included 21 neuropsychological tests, from which summary measures of global cognitive function and 5 functional domains were formed, and clinical classification of AD. Results: Random effects models were used to analyze change in cognitive function, and proportional hazards models were used to assess risk of incident AD. On average, men and women declined in all abilities during the 8-year period but did not differ in annual rates of change in analyses that controlled for age, education, and initial level of cognitive function. Risk of incident AD did not differ between men and women. Furthermore, results were unchanged after controlling for possession of the apolipoprotein-epsilon4 allele. Duration of estrogen use was related to rate of global cognitive decline and visuospatial abilities in women but did not influence comparisons between men and women in cognitive decline. Conclusions: The results suggest that patterns of cognitive decline and incidence of AD are similar in older men and women.