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Mian M, Tahiri J, Eldin R, Altabaa M, Sehar U, Reddy PH. Overlooked Cases of Mild Cognitive Impairment: Implications to Early Alzheimer's Disease. Ageing Res Rev 2024; 98:102335. [PMID: 38744405 DOI: 10.1016/j.arr.2024.102335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Revised: 05/02/2024] [Accepted: 05/08/2024] [Indexed: 05/16/2024]
Abstract
Mild cognitive impairment (MCI) marks the initial phase of memory decline or other cognitive functions like language or spatial perception, while individuals typically retain the capacity to carry out everyday tasks independently. Our comprehensive article investigates the intricate landscape of cognitive disorders, focusing on MCI and Alzheimer's disease (AD) and Alzheimer's disease-related dementias (ADRD). The study aims to understand the signs of MCI, early Alzheimer's disease, and healthy brain aging while assessing factors influencing disease progression, pathology development and susceptibility. A systematic literature review of over 100 articles was conducted, emphasizing MCI, AD and ADRD within the elderly populations. The synthesis of results reveals significant findings regarding ethnicity, gender, lifestyle, comorbidities, and diagnostic tools. Ethnicity was found to influence MCI prevalence, with disparities observed across diverse populations. Gender differences were evident in cognitive performance and decline, highlighting the need for personalized management strategies. Lifestyle factors and comorbidities were identified as crucial influencers of cognitive health. Regarding diagnostic tools, the Montreal Cognitive Assessment (MoCA) emerged as superior to the Mini-Mental State Examination (MMSE) in early MCI detection. Overall, our article provides insights into the multifaceted nature of cognitive disorders, emphasizing the importance of tailored interventions and comprehensive assessment strategies for effective cognitive health management.
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Affiliation(s)
- Maamoon Mian
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, 79430, TX, USA.
| | - Jihane Tahiri
- School of Biology, Texas Tech University, Lubbock, 79430, TX, USA.
| | - Ryan Eldin
- Department of Biomedical Sciences, Texas A&M University College of Dentistry, Dallas, TX 75246.
| | - Mohamad Altabaa
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, 79430, TX, USA.
| | - Ujala Sehar
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, 79430, TX, USA.
| | - P Hemachandra Reddy
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, 79430, TX, USA; Nutritional Sciences Department, College Human Sciences, Texas Tech University, Lubbock, TX 79409; Department of Pharmacology and Neuroscience, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA; Department of Neurology, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA; Department of Public Health, Graduate School of Biomedical Sciences, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA; Department of Speech, Language, and Hearing Sciences, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA.
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Hasnain N, Arif TB, Shafaut R, Zakaria F, Fatima SZ, Haque IU. Association between sex and Huntington's disease: an updated review on symptomatology and prognosis of neurodegenerative disorders. Wien Med Wochenschr 2024; 174:87-94. [PMID: 35723821 DOI: 10.1007/s10354-022-00941-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 05/16/2022] [Indexed: 10/18/2022]
Abstract
Huntington's disease is a rare autosomal dominant disorder presenting with chorea, rigidity, hypo-/akinesia, cognitive decline, and psychiatric disturbances. Numerous risk factors have been defined in the onset of this disease. However, the number of CAG repeats in the genes are the most crucial factor rendering patients susceptible to the disease. Studies have shown significant differences in onset and disease presentation among the sexes, which prompts analysis of the impact of different sexes on disease etiology and progression. This article therefore discusses the evidence-based role of sex in aspects of symptomatology, pathogenesis, biomarkers, progression, and prognosis of Huntington's disease, with a secondary review of sex-linked differences in Alzheimer's and Parkinson's disease.
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Affiliation(s)
- Nimra Hasnain
- Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan
- Department of Medicine, Dr. Ruth K. M. Pfao Civil Hospital, Karachi, Pakistan
| | - Taha Bin Arif
- Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan.
- Department of Medicine, Dr. Ruth K. M. Pfao Civil Hospital, Karachi, Pakistan.
| | - Roha Shafaut
- Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan
| | - Faiza Zakaria
- Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan
| | | | - Ibtehaj Ul Haque
- Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan
- Department of Medicine, Dr. Ruth K. M. Pfao Civil Hospital, Karachi, Pakistan
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Wang X, Sundermann EE, Buckley RF, Banks SJ. Sex differences in the association between tau PET and cognitive performance in a non-Hispanic White cohort with preclinical AD. Alzheimers Dement 2024; 20:25-33. [PMID: 37641484 PMCID: PMC10916995 DOI: 10.1002/alz.13432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 07/21/2023] [Accepted: 07/27/2023] [Indexed: 08/31/2023]
Abstract
INTRODUCTION We investigated how the associations between tau and cognitive measures differ by sex in the preclinical Alzheimer's disease (AD) stage. METHODS A total of 343 cognitively unimpaired, amyloid-positive individuals (205 women, 138 men) who self-identified as non-Hispanic White from the Anti-Amyloid Treatment in Asymptomatic Alzheimer's (A4) Study were included. We assessed sex-stratified associations between 18 F-flortaucipir positron emission tomography (PET) standardized uptake value ratio (SUVR) in the meta-temporal region and Preclinical Alzheimer's Cognitive Composite (PACC) and Computerized Cognitive Composite (C3) components. RESULTS We observed that higher tau level was significantly associated with worse cognitive performance only in women: PACC and its components except for Mini-Mental State Examination (MMSE) and C3 components: First Letter Name Recall (FNLT) and One-Card Learning Reaction Time (OCL RT). These associations except for FNLT were apolipoprotein E (APOE) ε4 independent. DISCUSSION Women show stronger associations between tau PET and cognitive outcomes in preclinical AD. These findings have important implications for sex-specific tau-targeted preventive AD clinical trials. HIGHLIGHTS The tau positron emission tomography (PET) signal in the meta-temporal region was associated with poor cognitive performance in preclinical Alzheimer's disease (AD). After sex stratification, the associations between regional tau PET and cognitive outcomes were observed only in women. The associations between tau PET and some cognitive outcomes were independent of apolipoprotein E (APOE) ε4.
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Affiliation(s)
- Xin Wang
- Department of NeurosciencesUniversity of CaliforniaSan DiegoCaliforniaUSA
| | | | - Rachel F. Buckley
- Department of NeurologyMassachusetts General Hospital/Harvard Medical SchoolBostonMassachusettsUSA
| | - Sarah J. Banks
- Department of NeurosciencesUniversity of CaliforniaSan DiegoCaliforniaUSA
- Department of PsychiatryUniversity of CaliforniaSan DiegoCaliforniaUSA
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Harker SA, Al-Hassan L, Huentelman MJ, Braden BB, Lewis CR. APOE ε4-Allele in Middle-Aged and Older Autistic Adults: Associations with Verbal Learning and Memory. Int J Mol Sci 2023; 24:15988. [PMID: 37958971 PMCID: PMC10650864 DOI: 10.3390/ijms242115988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 11/02/2023] [Accepted: 11/03/2023] [Indexed: 11/15/2023] Open
Abstract
Autism spectrum disorder (ASD) is a neurodevelopmental disability and recent evidence suggests that autistic adults are more likely to develop Alzheimer's disease (Alz) and other dementias compared to neurotypical (NT) adults. The ε4-allele of the Apolipoprotein E (APOE) gene is the strongest genetic risk factor for Alz and negatively impacts cognition in middle-aged and older (MA+) adults. This study aimed to determine the impact of the APOE ε4-allele on verbal learning and memory in MA+ autistic adults (ages 40-71 years) compared to matched NT adults. Using the Auditory Verbal Learning Test (AVLT), we found that ε4 carriers performed worse on short-term memory and verbal learning across diagnosis groups, but there was no interaction with diagnosis. In exploratory analyses within sex and diagnosis groups, only autistic men carrying APOE ε4 showed worse verbal learning (p = 0.02), compared to autistic men who were not carriers. Finally, the APOE ε4-allele did not significantly affect long-term memory in this sample. These findings replicate previous work indicating that the APOE ε4-allele negatively impacts short-term memory and verbal learning in MA+ adults and presents new preliminary findings that MA+ autistic men may be vulnerable to the effects of APOE ε4 on verbal learning. Future work with a larger sample is needed to determine if autistic women may also be vulnerable.
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Affiliation(s)
- Samantha A. Harker
- School of Life Sciences and Psychology, Arizona State University, Tempe, AZ 85287, USA;
- College of Health Solutions, Arizona State University, Tempe, AZ 85287, USA; (L.A.-H.); (B.B.B.)
| | - Lamees Al-Hassan
- College of Health Solutions, Arizona State University, Tempe, AZ 85287, USA; (L.A.-H.); (B.B.B.)
| | - Matthew J. Huentelman
- Neurogenomics Division, Translational Genomics Research Institute, Phoenix, AZ 85004, USA;
| | - B. Blair Braden
- College of Health Solutions, Arizona State University, Tempe, AZ 85287, USA; (L.A.-H.); (B.B.B.)
| | - Candace R. Lewis
- School of Life Sciences and Psychology, Arizona State University, Tempe, AZ 85287, USA;
- Neurogenomics Division, Translational Genomics Research Institute, Phoenix, AZ 85004, USA;
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Nester CO, Qin J, Wang C, Katz MJ, Lipton RB, Rabin LA. Concordance Between Logical Memory and Craft Story 21 in Community-Dwelling Older Adults: The Role of Demographic Factors And Cognitive Status. Arch Clin Neuropsychol 2023; 38:1091-1105. [PMID: 36533453 PMCID: PMC11004933 DOI: 10.1093/arclin/acac102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/20/2022] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVE Episodic memory loss, a hallmark symptom of Alzheimer's Disease, is frequently quantified by story memory performance. The National Alzheimer's Coordinating Center Uniform Data Set Neuropsychological Battery (UDSNB) replaced Logical Memory with Craft Story 21 in UDSNB Version 3. The concordance between these story memory tasks is poorly characterized in demographically diverse older adults, possibly jeopardizing the integrity of longitudinal data in aging cohorts. METHOD Einstein Aging Study participants (n = 298; Mage = 76.6; Meducation = 15; 66.4% women; 43.3% Non-Hispanic White) completed UDSNB measures, including Craft Story and Logical Memory. Classification as normal cognition (n = 206) or mild cognitive impairment (n = 90) was based on Jak/Bondi criteria. Analyses included correlations, linear regression, and equipercentile equating methods to characterize the relationship between Logical Memory and Craft Story. Multivariate linear mixed effects models explored the association of covariates and practice effects over follow-up, stratified by cognitive status and race/ethnicity. RESULTS Immediate (r = 0.54) and delayed (r = 0.56) versions of Logical Memory and Craft Story were moderately correlated. Age, education, depression, and female sex were associated with Logical Memory, while age, education, cognitive status, and male sex were associated with Craft Story. Significant differential effects of sex on story memory were observed. CONCLUSIONS We demonstrated that Logical Memory and Craft Story may be used largely interchangeably; however, memory may be enhanced for stories with a protagonist of the same sex as the participant. Craft Story was somewhat more associated with mild cognitive impairment in the overall sample, but especially in non-Hispanic Black participants. We discuss how results inform test selection considerations.
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Affiliation(s)
- Caroline O Nester
- Department of Psychology, Queens College, City University of New York (CUNY), Queens, NY, USA
- Department of Psychology, Brooklyn College, City University of New York (CUNY), Brooklyn, NY, USA
- Department of Psychology, The Graduate Center, City University of New York (CUNY), New York, NY, USA
| | - Jiyue Qin
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Cuiling Wang
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
- Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Mindy J Katz
- Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Richard B Lipton
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
- Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Laura A Rabin
- Department of Psychology, Brooklyn College, City University of New York (CUNY), Brooklyn, NY, USA
- Department of Psychology, The Graduate Center, City University of New York (CUNY), New York, NY, USA
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Ramli NZ, Yahaya MF, Mohd Fahami NA, Abdul Manan H, Singh M, Damanhuri HA. Brain volumetric changes in menopausal women and its association with cognitive function: a structured review. Front Aging Neurosci 2023; 15:1158001. [PMID: 37818479 PMCID: PMC10561270 DOI: 10.3389/fnagi.2023.1158001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 09/04/2023] [Indexed: 10/12/2023] Open
Abstract
The menopausal transition has been proposed to put women at risk for undesirable neurological symptoms, including cognitive decline. Previous studies suggest that alterations in the hormonal milieu modulate brain structures associated with cognitive function. This structured review provides an overview of the relevant studies that have utilized MRI to report volumetric differences in the brain following menopause, and its correlations with the evaluated cognitive functions. We performed an electronic literature search using Medline (Ovid) and Scopus to identify studies that assessed the influence of menopause on brain structure with MRI. Fourteen studies met the inclusion criteria. Brain volumetric differences have been reported most frequently in the frontal and temporal cortices as well as the hippocampus. These regions are important for higher cognitive tasks and memory. Additionally, the deficit in verbal and visuospatial memory in postmenopausal women has been associated with smaller regional brain volumes. Nevertheless, the limited number of eligible studies and cross-sectional study designs warrant further research to draw more robust conclusions.
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Affiliation(s)
- Nur Zuliani Ramli
- Department of Biochemistry, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
- Department of Biomedical Sciences, Faculty of Medicine & Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Malaysia
| | - Mohamad Fairuz Yahaya
- Department of Anatomy, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Nur Azlina Mohd Fahami
- Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Hanani Abdul Manan
- Functional Image Processing Laboratory, Department of Radiology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Meharvan Singh
- Department of Cell and Molecular Physiology, Stritch School of Medicine, Loyola University Chicago, Maywood, IL, United States
| | - Hanafi Ahmad Damanhuri
- Department of Biochemistry, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
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Gagliardi G, Rodriguez-Vieitez E, Montal V, Sepulcre J, Diez I, Lois C, Hanseeuw B, Schultz AP, Properzi MJ, Papp KV, Marshall GA, Fortea J, Johnson KA, Sperling RA, Vannini P. Cortical microstructural changes predict tau accumulation and episodic memory decline in older adults harboring amyloid. COMMUNICATIONS MEDICINE 2023; 3:106. [PMID: 37528163 PMCID: PMC10394044 DOI: 10.1038/s43856-023-00324-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 06/19/2023] [Indexed: 08/03/2023] Open
Abstract
INTRODUCTION Non-invasive diffusion-weighted imaging (DWI) to assess brain microstructural changes via cortical mean diffusivity (cMD) has been shown to be cross-sectionally associated with tau in cognitively normal older adults, suggesting that it might be an early marker of neuronal injury. Here, we investigated how regional cortical microstructural changes measured by cMD are related to the longitudinal accumulation of regional tau as well as to episodic memory decline in cognitively normal individuals harboring amyloid pathology. METHODS 122 cognitively normal participants from the Harvard Aging Brain Study underwent DWI, T1w-MRI, amyloid and tau PET imaging, and Logical Memory Delayed Recall (LMDR) assessments. We assessed whether the interaction of baseline amyloid status and cMD (in entorhinal and inferior-temporal cortices) was associated with longitudinal regional tau accumulation and with longitudinal LMDR using separate linear mixed-effects models. RESULTS We find a significant interaction effect of the amyloid status and baseline cMD in predicting longitudinal tau in the entorhinal cortex (p = 0.044) but not the inferior temporal lobe, such that greater baseline cMD values predicts the accumulation of entorhinal tau in amyloid-positive participants. Moreover, we find a significant interaction effect of the amyloid status and baseline cMD in the entorhinal cortex (but not inferior temporal cMD) in predicting longitudinal LMDR (p < 0.001), such that baseline entorhinal cMD predicts the episodic memory decline in amyloid-positive participants. CONCLUSIONS The combination of amyloidosis and elevated cMD in the entorhinal cortex may help identify individuals at short-term risk of tau accumulation and Alzheimer's Disease-related episodic memory decline, suggesting utility in clinical trials.
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Affiliation(s)
- Geoffroy Gagliardi
- Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA
- Athinoula A. Martinos Center for Biomedical Imaging, Charlestown, MA, 02129, USA
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA, 02115, USA
| | - Elena Rodriguez-Vieitez
- Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA
- Athinoula A. Martinos Center for Biomedical Imaging, Charlestown, MA, 02129, USA
- Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Stockholm, 14152, Sweden
| | - Victor Montal
- Sant Pau Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Universitat Autònoma de Barcelona, Barcelona, 08041, Spain
- Centre of Biomedical Investigation Network for Neurodegenerative Diseases (CIBERNED), Madrid, 28031, Spain
| | - Jorge Sepulcre
- Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA
- Gordon Center for Medical Imaging, Boston, MA, 02114, USA
| | - Ibai Diez
- Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA
- Gordon Center for Medical Imaging, Boston, MA, 02114, USA
| | - Cristina Lois
- Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA
- Gordon Center for Medical Imaging, Boston, MA, 02114, USA
| | - Bernard Hanseeuw
- Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA
- Gordon Center for Medical Imaging, Boston, MA, 02114, USA
- Saint Luc University Hospital, Université Catholique de Louvain, Brussels, 1200, Belgium
| | - Aaron P Schultz
- Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA
- Athinoula A. Martinos Center for Biomedical Imaging, Charlestown, MA, 02129, USA
| | - Michael J Properzi
- Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA
| | - Kathryn V Papp
- Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA
- Athinoula A. Martinos Center for Biomedical Imaging, Charlestown, MA, 02129, USA
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA, 02115, USA
| | - Gad A Marshall
- Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA, 02115, USA
| | - Juan Fortea
- Sant Pau Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Universitat Autònoma de Barcelona, Barcelona, 08041, Spain
- Centre of Biomedical Investigation Network for Neurodegenerative Diseases (CIBERNED), Madrid, 28031, Spain
| | - Keith A Johnson
- Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA
- Gordon Center for Medical Imaging, Boston, MA, 02114, USA
| | - Reisa A Sperling
- Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA
- Athinoula A. Martinos Center for Biomedical Imaging, Charlestown, MA, 02129, USA
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA, 02115, USA
| | - Patrizia Vannini
- Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA.
- Athinoula A. Martinos Center for Biomedical Imaging, Charlestown, MA, 02129, USA.
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA, 02115, USA.
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Katabathula S, Davis PB, Xu R. Sex-Specific Heterogeneity of Mild Cognitive Impairment Identified Based on Multi-Modal Data Analysis. J Alzheimers Dis 2023; 91:233-243. [PMID: 36404544 DOI: 10.3233/jad-220600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Mild cognitive impairment (MCI), a prodromal phase of Alzheimer's disease (AD), is heterogeneous with different rates and risks of progression to AD. There are significant gender disparities in the susceptibility, prognosis, and outcomes in patients with MCI, with female being disproportionately negatively impacted. OBJECTIVE The aim of this study was to identify sex-specific heterogeneity of MCI using multi-modality data and examine the differences in the respective MCI subtypes with different prognostic outcomes or different risks for MCI to AD conversion. METHODS A total of 325 MCI subjects (146 women, 179 men) and 30 relevant features were considered. Mixed-data clustering was applied to women and men separately to discover gender-specific MCI subtypes. Gender differences were compared in the respective subtypes of MCI by examining their MCI to AD disease prognosis, descriptive statistics, and conversion rates. RESULTS We identified three MCI subtypes: poor-, good-, and best-prognosis for women and for men, separately. The subtype-wise comparison (for example, poor-prognosis subtype in women versus poor-prognosis subtype in men) showed significantly different means for brain volumetric, cognitive test-related, also for the proportion of comorbidities. Also, there were substantial gender differences in the proportions of participants who reverted to normal function, remained stable, or converted to AD. CONCLUSION Analyzing sex-specific heterogeneity of MCI offers the opportunity to advance the understanding of the pathophysiology of both MCI and AD, allows stratification of risk in clinical trials of interventions, and suggests gender-based early intervention with targeted treatment for patients at risk of developing AD.
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Affiliation(s)
- Sreevani Katabathula
- Center for Artificial Intelligence in Drug Discovery, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Pamela B Davis
- Center for Community Health Integration, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Rong Xu
- Center for Artificial Intelligence in Drug Discovery, Case Western Reserve University School of Medicine, Cleveland, OH, USA
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Chang YL, Moscovitch M. Sex differences in item and associative memory among older adults with amnestic mild cognitive impairment. Neuropsychologia 2022; 176:108375. [PMID: 36179862 DOI: 10.1016/j.neuropsychologia.2022.108375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 09/01/2022] [Accepted: 09/22/2022] [Indexed: 10/31/2022]
Abstract
In older adults without cognitive impairment, women have an advantage over men in verbal memory tests; however, whether women with amnestic mild cognitive impairment (aMCI) exhibit this advantage remains controversial. We evaluated sex-specific differences in older adults with and without aMCI in item and associative verbal memory by using an associative memory task with immediate and delayed recognition conditions. The associations between memory task performances and medial temporal morphometric measures were examined. The study included 49 individuals with aMCI and 55 healthy older adults (HOs). The results revealed that a female advantage in immediate item and delayed associative memory was evident in HOs, and the female advantage in associative memory persisted even after item memory performance was controlled. By contrast, the female advantage was absent in individuals with aMCI; such women had more associative false alarms than men with aMCI. Furthermore, decreases in item memory, associative memory, and cortical thickness in the perirhinal and entorhinal regions in individuals with aMCI versus their sex-matched controls were more prominent in women than in men. The relation between brain structure and associative memory function was evident only for women, indicating that women and men may have different cognitive and neural mechanisms for processing associative memory. These findings support the concept of cognitive reserve in women during normal aging. Accounting for sex differences in verbal memory performance is crucial to improve aMCI identification, particularly for women.
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Affiliation(s)
- Yu-Ling Chang
- Department of Psychology, College of Science, National Taiwan University, Taipei, 10617, Taiwan; Neurobiology and Cognitive Science Center, National Taiwan University, Taipei, 10617, Taiwan; Department of Neurology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, 10048, Taiwan; Center for Artificial Intelligence and Advanced Robotics, National Taiwan University, Taipei, 10617, Taiwan.
| | - Morris Moscovitch
- Rotman Research Institute, Baycrest Health Sciences, Toronto, ON M6A 2E1, Canada; Department of Psychology, University of Toronto, Toronto, ON M5S 3G3, Canada
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10
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Luo L, Wang G, Zhou H, Zhang L, Ma CXN, Little JP, Yu Z, Teng H, Yin JY, Wan Z. Sex-specific longitudinal association between baseline physical activity level and cognitive decline in Chinese over 45 years old: Evidence from the China health and retirement longitudinal study. Aging Ment Health 2022; 26:1721-1729. [PMID: 34166602 DOI: 10.1080/13607863.2021.1935456] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVES To examine whether sex-specific associations between baseline PA level and follow up cognitive performance in Chinese subjects exist from the China Health and Retirement Longitudinal study (CHARLS). METHOD A total of 3395 adults aged 45 or old from the CHARLS were used for analysis. The combined scores of measurements of mental status and verbal episodic memory were utilized for assessing cognitive function at baseline in 2011 and the follow-up survey in 2015. Baseline PA level was quantified as the total PA score. Multiple linear regression and logistic regression models were used to examine the association between baseline PA status and global cognitive function and cognitive domains. RESULTS In the female subjects (n = 1748), compared with individuals of PA level in the lower tertile, those grouped into the upper tertile had the lowest risk of global cognitive decline [odds ratio (OR) =0.273, 95% confidence interval (CI) =0.077-0.960; p = 0.043] and verbal episodic memory decline [OR)=0.257, 95% CI =0.066-1.003; p = 0.051] from 2011 to 2015. However, no significant associations were observed in the male subjects (n = 1647). CONCLUSION In the female subjects, higher PA level was associated with reduced risk of cognitive decline within 4 years, this might be associated with reduced decline of verbal episodic memory. Our findings confirmed that female sex would positively affect the association between PA levels and cognitive decline.
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Affiliation(s)
- Lan Luo
- School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Guiping Wang
- School of Physical Education, Soochow University, Suzhou, China.,Laboratory Animal Center, Medical college of Soochow University, Suzhou, China
| | - Huanhuan Zhou
- School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Lin Zhang
- School of Physical Education, Soochow University, Suzhou, China
| | - Chen-Xi-Nan Ma
- School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Jonathan P Little
- School of Health and Exercise Sciences, University of British Columbia, Kelowna, British Columbia, Canada
| | - Zengli Yu
- College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Haoyue Teng
- School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Jie-Yun Yin
- School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Zhongxiao Wan
- School of Public Health, Medical College of Soochow University, Suzhou, China.,College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
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Guglietti B, Hobbs D, Collins-Praino LE. Optimizing Cognitive Training for the Treatment of Cognitive Dysfunction in Parkinson's Disease: Current Limitations and Future Directions. Front Aging Neurosci 2021; 13:709484. [PMID: 34720988 PMCID: PMC8549481 DOI: 10.3389/fnagi.2021.709484] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 08/17/2021] [Indexed: 01/09/2023] Open
Abstract
Cognitive dysfunction, primarily involving impairments in executive function, visuospatial function and memory, is one of the most common non-motor symptoms of Parkinson’s disease (PD). Currently, the only pharmacological treatments available for the treatment of cognitive dysfunction in PD provide variable benefit, making the search for potential non-pharmacological therapies to improve cognitive function of significant interest. One such therapeutic strategy may be cognitive training (CT), which involves the repetition of standardized tasks with the aim of improving specific aspects of cognition. Several studies have examined the effects of CT in individuals with PD and have shown benefits in a variety of cognitive domains, but the widespread use of CT in these individuals may be limited by motor impairments and other concerns in study design. Here, we discuss the current state of the literature on the use of CT for PD and propose recommendations for future implementation. We also explore the potential use of more recent integrative, adaptive and assistive technologies, such as virtual reality, which may optimize the delivery of CT in PD.
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Affiliation(s)
- Bianca Guglietti
- Cognition, Ageing and Neurodegenerative Disease Laboratory, Department of Medical Sciences, Adelaide Medical School, The University of Adelaide, Adelaide, SA, Australia
| | - David Hobbs
- Medical Device Research Institute, College of Science and Engineering, Flinders University, Tonsley, SA, Australia.,Allied Health & Human Performance, University of South Australia, Adelaide, SA, Australia
| | - Lyndsey E Collins-Praino
- Cognition, Ageing and Neurodegenerative Disease Laboratory, Department of Medical Sciences, Adelaide Medical School, The University of Adelaide, Adelaide, SA, Australia
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12
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Elosúa MR, Ciudad MJ, Contreras MJ. Executive-function tasks in patients with mild cognitive impairment and Alzheimer's Disease: Effects of decline and gender. APPLIED NEUROPSYCHOLOGY-ADULT 2021:1-7. [PMID: 34362278 DOI: 10.1080/23279095.2021.1961142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
It is exceedingly rare to find studies that analyze the effect of gender differences in executive-function tasks in normal cognitive aging, Mild Cognitive Impairment (MCI) and Alzheimer's Disease (AD). The objective of the present study was to analyze the mean differences in performance in four executive-function tasks, the Clock Drawing Test verbal-command, Clock Drawing Test-copy, Phonetic Fluency Test and Trail Making Test-A, according to the gender and impairment group variables. A total of 90 participants (30 patients with Alzheimer's Disease, 30 patients with Mild Cognitive Impairment, and 30 healthy elderly participants; 50% men and 50% women in each group) took part in the study. As expected, the results showed a main effect of the group in most tasks, with a progressively worse performance according to cognitive impairment. Regarding the effect of gender, there were no significant differences in the Mild Cognitive Impairment and healthy elderly groups, but a significantly higher performance of women compared to men was found in the Alzheimer's group. The clinical and theoretical implications of these results are discussed. In particular, the abnormal performance of women with Alzheimer's in the sample may be related to a possible cognitive reserve due to social and educational background in their sociocultural and generational context.
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Affiliation(s)
- M Rosa Elosúa
- Psicología Básica I, Universidad Nacional de Educación a Distancia, Madrid, Spain
| | - Maria José Ciudad
- Badalona Serveis Assistencials, Servicio de Geriatría y Curas Paliativas, Departamento de Psicología Básica I, Universidad Nacional de Educacion a Distancia, Madrid, Spain
| | - Maria José Contreras
- Departamento de Psicología Básica I, Universidad Nacional de Educación a Distancia, Madrid, Spain
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13
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Cuervo-Zanatta D, Garcia-Mena J, Perez-Cruz C. Gut Microbiota Alterations and Cognitive Impairment Are Sexually Dissociated in a Transgenic Mice Model of Alzheimer's Disease. J Alzheimers Dis 2021; 82:S195-S214. [PMID: 33492296 DOI: 10.3233/jad-201367] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Normal aging is accompanied by cognitive deficiencies, affecting women and men equally. Aging is the main risk factor for Alzheimer's disease (AD), with women having a higher risk. The higher prevalence of AD in women is associated with the abrupt hormonal decline seen after menopause. However, other factors may be involved in this sex-related cognitive decline. Alterations in gut microbiota (GM) and its bioproducts have been reported in AD subjects and transgenic (Tg) mice, having a direct impact on brain amyloid-β pathology in male (M), but not in female (F) mice. OBJECTIVE The aim of this work was to determine GM composition and cognitive dysfunction in M and F wildtype (WT) and Tg mice, in a sex/genotype segregation design. METHODS Anxiety, short term working-memory, spatial learning, and long-term spatial memory were evaluated in 6-month-old WT and Tg male mice. Fecal short chain fatty acids were determined by chromatography, and DNA sequencing and bioinformatic analyses were used to determine GM differences. RESULTS We observed sex-dependent differences in cognitive skills in WT mice, favoring F mice. However, the cognitive advantage of females was lost in Tg mice. GM composition showed few sex-related differences in WT mice. Contrary, Tg-M mice presented a more severe dysbiosis than Tg-F mice. A decreased abundance of Ruminococcaceae was associated with cognitive deficits in Tg-F mice, while butyrate levels were positively associated with better working- and object recognition-memory in WT-F mice. CONCLUSION This report describes a sex-dependent association between GM alterations and cognitive impairment in a mice model of AD.
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Affiliation(s)
- Daniel Cuervo-Zanatta
- Pharmacology Department, Center for Research and Advanced Studies of the National Polytechnic Institute (Cinvestav), Laboratory of Neuroplasticity and Neurodegeneration, Mexico City, Mexico.,Genetics and Molecular Biology Department, Center for Research and Advanced Studies of the National Polytechnic Institute (Cinvestav), Laboratory of reference and support for the characterization of genomes, transcriptomes and microbiomes, Mexico City, Mexico
| | - Jaime Garcia-Mena
- Genetics and Molecular Biology Department, Center for Research and Advanced Studies of the National Polytechnic Institute (Cinvestav), Laboratory of reference and support for the characterization of genomes, transcriptomes and microbiomes, Mexico City, Mexico
| | - Claudia Perez-Cruz
- Pharmacology Department, Center for Research and Advanced Studies of the National Polytechnic Institute (Cinvestav), Laboratory of Neuroplasticity and Neurodegeneration, Mexico City, Mexico
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14
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The Past as Seen by Women and Men With Alzheimer Disease: Sex Differences in Autobiographical Memory. Alzheimer Dis Assoc Disord 2021; 34:170-174. [PMID: 31913962 DOI: 10.1097/wad.0000000000000363] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Although there is a large body of research demonstrating the negative effects of Alzheimer disease (AD) on autobiographical memory (ie, memory of personal information), little is known about sex differences in autobiographical retrieval in AD. METHODS We addressed this issue by inviting patients with AD and healthy control participants to retrieve autobiographical memories and analyzed them with regard to specificity, subjective experience (ie, time travel, emotion, and visual imagery), and retrieval time. RESULTS Analyses demonstrated no significant differences between women and men with AD with regard to autobiographical specificity, time travel, visual imagery, or retrieval time. However, the higher emotional value was attributed to memories by women with AD than by men with AD. DISCUSSION AD seems to equally affect the ability of women and men with AD to construct specific autobiographical memories, to mentally travel in time to relive these memories, to construct mental visual images during memory retrieval, and to organize and monitor search processes, as the latter are mirrored by retrieval time. However, women with AD seem to attribute greater emotional value to autobiographical memories than men with AD.
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Roheger M, Kalbe E, Corbett A, Brooker H, Ballard C. Predictors of changes after reasoning training in healthy adults. Brain Behav 2020; 10:e01861. [PMID: 32981211 PMCID: PMC7749593 DOI: 10.1002/brb3.1861] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 09/10/2020] [Accepted: 09/10/2020] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES To investigate predictors of performance changes and their time course in healthy older adults. DESIGN A post hoc analysis of a RCT investigating the effect of reasoning cognitive training (ReaCT) compared to an active control group (CG) during a time course. SETTING AND PARTICIPANTS An online, home-based RCT including n = 4,310 healthy participants (ReaCT: n = 2,557; CG: n = 1,753) aged 50 years and older. METHODS Multiple regression analyses were conducted to investigate predictors (age, sex, education, severity of depression, number of training sessions the participants attended, and neuropsychological baseline values) of the outcome measures grammatical reasoning, working memory, digit vigilance, verbal short-term memory, and verbal learning at 6 weeks, 3, and 6 months. RESULTS Being female and lower education predicted improvements in grammatical reasoning scores at 6 weeks and 3 months of training. CONCLUSION AND IMPLICATION Identifying predictors for nonpharmacological interventions may help to set up a personalized medicine approach in order to prevent cognitive decline in healthy older adults.
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Affiliation(s)
- Mandy Roheger
- Department of Medical Psychology, Neuropsychology and Gender Studies & Center for Neuropsychological Diagnostics and Intervention (CeNDI), Faculty of Medicine and University Hospital Cologne, Cologne, Germany.,Department of Neurology, University Medicine Greifswald, Greifswald, Germany
| | - Elke Kalbe
- Department of Medical Psychology, Neuropsychology and Gender Studies & Center for Neuropsychological Diagnostics and Intervention (CeNDI), Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Anne Corbett
- Institute of Health Research, University of Exeter Medical School, University of Exeter, Exeter, UK
| | - Helen Brooker
- Institute of Health Research, University of Exeter Medical School, University of Exeter, Exeter, UK
| | - Clive Ballard
- Institute of Health Research, University of Exeter Medical School, University of Exeter, Exeter, UK
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Ophey A, Roheger M, Folkerts AK, Skoetz N, Kalbe E. A Systematic Review on Predictors of Working Memory Training Responsiveness in Healthy Older Adults: Methodological Challenges and Future Directions. Front Aging Neurosci 2020; 12:575804. [PMID: 33173503 PMCID: PMC7591761 DOI: 10.3389/fnagi.2020.575804] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 08/26/2020] [Indexed: 12/15/2022] Open
Abstract
Background: Research on predictors of working memory training responsiveness, which could help tailor cognitive interventions individually, is a timely topic in healthy aging. However, the findings are highly heterogeneous, reporting partly conflicting results following a broad spectrum of methodological approaches to answer the question “who benefits most” from working memory training. Objective: The present systematic review aimed to systematically investigate prognostic factors and models for working memory training responsiveness in healthy older adults. Method: Four online databases were searched up to October 2019 (MEDLINE Ovid, Web of Science, CENTRAL, and PsycINFO). The inclusion criteria for full texts were publication in a peer-reviewed journal in English/German, inclusion of healthy older individuals aged ≥55 years without any neurological and/or psychiatric diseases including cognitive impairment, and the investigation of prognostic factors and/or models for training responsiveness after targeted working memory training in terms of direct training effects, near-transfer effects to verbal and visuospatial working memory as well as far-transfer effects to other cognitive domains and behavioral variables. The study design was not limited to randomized controlled trials. Results: A total of 16 studies including n = 675 healthy older individuals with a mean age of 63.0–86.8 years were included in this review. Within these studies, five prognostic model approaches and 18 factor finding approaches were reported. Risk of bias was assessed using the Quality in Prognosis Studies checklist, indicating that important information, especially regarding the domains study attrition, study confounding, and statistical analysis and reporting, was lacking throughout many of the investigated studies. Age, education, intelligence, and baseline performance in working memory or other cognitive domains were frequently investigated predictors across studies. Conclusions: Given the methodological shortcomings of the included studies, no clear conclusions can be drawn, and emerging patterns of prognostic effects will have to survive sound methodological replication in future attempts to promote precision medicine approaches in the context of working memory training. Methodological considerations are discussed, and our findings are embedded to the cognitive aging literature, considering, for example, the cognitive reserve framework and the compensation vs. magnification account. The need for personalized cognitive prevention and intervention methods to counteract cognitive decline in the aging population is high and the potential enormous. Registration: PROSPERO, ID CRD42019142750.
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Affiliation(s)
- Anja Ophey
- Department of Medical Psychology
- Neuropsychology & Gender Studies, Center for Neuropsychological Diagnostics and Intervention (CeNDI), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Mandy Roheger
- Department of Medical Psychology
- Neuropsychology & Gender Studies, Center for Neuropsychological Diagnostics and Intervention (CeNDI), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Ann-Kristin Folkerts
- Department of Medical Psychology
- Neuropsychology & Gender Studies, Center for Neuropsychological Diagnostics and Intervention (CeNDI), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Nicole Skoetz
- Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany
| | - Elke Kalbe
- Department of Medical Psychology
- Neuropsychology & Gender Studies, Center for Neuropsychological Diagnostics and Intervention (CeNDI), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
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17
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Chang KH, Huang CC, Chen CM, Wu HC, Kuo HC. Differences in Clinical Presentation of Behavioral and Psychological Symptoms of Dementia in Alzheimer's Disease According to Sex and Education Level. J Alzheimers Dis 2020; 78:711-719. [PMID: 33044179 DOI: 10.3233/jad-200507] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The behavioral and psychological symptoms of dementia (BPSD) seriously affect the quality of life of patients with Alzheimer's disease (AD) and their caregivers. OBJECTIVE We aimed to identify associations between demographic/genetic factors and clinical presentations of BPSD. METHODS In a cohort of 463 AD patients with BPSD, we retrospectively analyzed sex, education level, AD severity (assessed using the Clinical Dementia Rating and Mini-Mental Status Examination), and BPSD severity (assessed using the Neuropsychiatry Inventory, NPI). Severe BPSD was defined as NPI ≥10 for 3 consecutive years. RESULTS Among patients with severe BPSD (NPI ≥10), we observed more female patients (62.96%) and a lower level of education (6.03±4.77 years) as compared to those with mild BPSD (NPI <10) (female: 51.09%, p = 0.007; education years: 7.91±4.93, p < 0.001). Females had a lower level of education (5.72±4.50 years) and higher scores for depression/dysphoria (1.22±2.05) compared with males (education: 8.96±4.89 years, p < 0.001; depression/dysphoria: 0.78±1.42, p = 0.047). Patients with a high level of education (defined as ≥12 years) had higher scores for appetite/eating (0.90±2.02) than did those without (0.69±1.79; p = 0.001). Genetic analysis showed similar total and subscale NPI scores between patients with and without APOE4 and with and without the GRN rs5848 genotype. CONCLUSION Our findings indicate potential contributions of sex and education to the presentation of BPSD. Further study is warranted to provide models for tailoring therapeutic programs to individual AD patients according to these factors.
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Affiliation(s)
- Kuo-Hsuan Chang
- Department of Neurology, Chang Gung Memorial Hospital-Linkou Medical Center, Taoyuan, Taiwan.,School of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chin-Chang Huang
- Department of Neurology, Chang Gung Memorial Hospital-Linkou Medical Center, Taoyuan, Taiwan.,School of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chiung-Mei Chen
- Department of Neurology, Chang Gung Memorial Hospital-Linkou Medical Center, Taoyuan, Taiwan.,School of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Hsiu-Chuan Wu
- Department of Neurology, Chang Gung Memorial Hospital-Linkou Medical Center, Taoyuan, Taiwan.,School of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Hung-Chou Kuo
- Department of Neurology, Chang Gung Memorial Hospital-Linkou Medical Center, Taoyuan, Taiwan.,School of Medicine, Chang Gung University, Taoyuan, Taiwan
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18
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Roheger M, Folkerts AK, Krohm F, Skoetz N, Kalbe E. Prognostic Models for Changes in Memory Performance After Memory Training in Healthy Older Adults: a Systematic Review. JOURNAL OF COGNITIVE ENHANCEMENT 2020. [DOI: 10.1007/s41465-020-00194-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AbstractIdentifying individuals’ profiles of prognostic factors that predict improvements after nonpharmacological interventions such as memory trainings may help to not only predict individuals’ future outcomes after such intervention, but also tailor new trainings for individuals with specific characteristics. However, until now, no systematic review on prognostic models, defined as a set of multiple prognostic factors to predict a future outcome, for changes in memory performance after memory training exist. MEDLINE, Web of Science Core Collection, CENTRAL, and PsycInfo were searched up to November 2019 to identify studies investigating prognostic models on verbal and non-verbal short- and long-term memory after conducting memory training in healthy older adults. The PROBAST tool was used to assess risk of bias. After screening n = 10,703 studies, n = 12 studies were included. These studies and the investigated statistical models are highly heterogeneous, so that conclusions are limited. However, one consistent result was that lower age combined with higher education seems to predict higher improvements after memory training. More studies on prognostic models for memory changes after memory training have to be conducted before clear conclusions which will help to tailor memory trainings to individuals’ profiles can be drawn. Registration: CRD42018105803, https://www.crd.york.ac.uk/PROSPERO
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19
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Roheger M, Kalbe E, Corbett A, Brooker H, Ballard C. Lower cognitive baseline scores predict cognitive training success after 6 months in healthy older adults: Results of an online RCT. Int J Geriatr Psychiatry 2020; 35:1000-1008. [PMID: 32363656 DOI: 10.1002/gps.5322] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 04/22/2020] [Accepted: 04/25/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND Identifying predictors for general cognitive training (GCT) success in healthy older adults has many potential uses, including aiding intervention and improving individual dementia risk prediction, which are of high importance in health care. However, the factors that predict training improvements and the temporal course of predictors (eg, do the same prognostic factors predict training success after a short training period, such as 6 weeks, as well as after a longer training period, such as 6 months?) are largely unknown. METHODS Data (N = 4,184 healthy older individuals) from two arms (GCT vs. control) of a three-arm randomized controlled trial were reanalyzed to investigate predictors of GCT success in five cognitive tasks (grammatical reasoning, spatial working memory, digit vigilance, paired association learning, and verbal learning) at three time points (after 6 weeks, 3 months, and 6 months of training). Possible investigated predictors were sociodemographic variables, depressive symptoms, number of training sessions, cognitive baseline values, and all interaction terms (group*predictor). RESULTS Being female was predictive for improvement in grammatical reasoning at 6 weeks in the GCT group, and lower cognitive baseline scores were predictive for improvement in spatial working memory and verbal learning at 6 months. CONCLUSION Our data indicate that predictors seem to change over time; remarkably, lower baseline performance at study entry is only a significant predictor at 6 months training. Possible reasons for these results are discussed in relation to the compensation hypothesis. J Am Geriatr Soc 68:-, 2020.
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Affiliation(s)
- Mandy Roheger
- Department of Medical Psychology, Neuropsychology and Gender Studies & Center for Neuropsychological Diagnostics and Intervention (CeNDI), University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany.,Department of Neurology, University Medicine Greifswald, Greifswald, Germany
| | - Elke Kalbe
- Department of Medical Psychology, Neuropsychology and Gender Studies & Center for Neuropsychological Diagnostics and Intervention (CeNDI), University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Anne Corbett
- Institute of Health Research, University of Exeter Medical School, University of Exeter, Exeter, UK
| | - Helen Brooker
- Institute of Health Research, University of Exeter Medical School, University of Exeter, Exeter, UK
| | - Clive Ballard
- Institute of Health Research, University of Exeter Medical School, University of Exeter, Exeter, UK
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20
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Digma LA, Madsen JR, Rissman RA, Jacobs DM, Brewer JB, Banks SJ. Women can bear a bigger burden: ante- and post-mortem evidence for reserve in the face of tau. Brain Commun 2020; 2:fcaa025. [PMID: 32337508 PMCID: PMC7166251 DOI: 10.1093/braincomms/fcaa025] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 12/28/2019] [Accepted: 01/23/2020] [Indexed: 01/08/2023] Open
Abstract
In this study, we aimed to assess whether women are able to withstand more tau before exhibiting verbal memory impairment. Using data from 121 amyloid-β-positive Alzheimer’s Disease Neuroimaging Initiative participants, we fit a linear model with Rey Auditory Verbal Learning Test score as the response variable and tau-PET standard uptake value ratio as the predictor and took the residuals as an estimate of verbal memory reserve for each subject. Women demonstrated higher reserve (i.e. residuals), whether the Learning (t = 2.78, P = 0.006) or Delay (t = 2.14, P = 0.03) score from the Rey Auditory Verbal Learning Test was used as a measure of verbal memory ability. To validate these findings, we examined 662 National Alzheimer’s Coordinating Center participants with a C2/C3 score (Consortium to Establish a Registry for Alzheimer’s Disease) at autopsy. We stratified our National Alzheimer’s Coordinating Center sample into Braak 1/2, Braak 3/4 and Braak 5/6 subgroups. Within each subgroup, we compared Logical Memory scores between men and women. Men had worse verbal memory scores within the Braak 1/2 (Logical Memory Immediate: β = −5.960 ± 1.517, P < 0.001, Logical Memory Delay: β = −5.703 ± 1.677, P = 0.002) and Braak 3/4 (Logical Memory Immediate: β = −2.900 ± 0.938, P = 0.002, Logical Memory Delay: β = −2.672 ± 0.955, P = 0.006) subgroups. There were no sex differences in Logical Memory performance within the Braak 5/6 subgroup (Logical Memory Immediate: β = −0.314 ± 0.328, P = 0.34, Logical Memory Delay: β = −0.195 ± 0.287, P = 0.50). Taken together, our results point to a sex-related verbal memory reserve.
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Affiliation(s)
- Leonardino A Digma
- Department of Neurosciences, University of California San Diego, La Jolla, CA 92093, USA
| | - John R Madsen
- Department of Neurosciences, University of California San Diego, La Jolla, CA 92093, USA
| | - Robert A Rissman
- Department of Neurosciences, University of California San Diego, La Jolla, CA 92093, USA.,Veteran's Administration San Diego Healthcare System, La Jolla, CA 92093, USA
| | - Diane M Jacobs
- Department of Neurosciences, University of California San Diego, La Jolla, CA 92093, USA
| | - James B Brewer
- Department of Neurosciences, University of California San Diego, La Jolla, CA 92093, USA.,Department of Radiology, University of California San Diego, La Jolla, CA 92093, USA
| | - Sarah J Banks
- Department of Neurosciences, University of California San Diego, La Jolla, CA 92093, USA.,Department of Psychiatry, University of California San Diego, La Jolla, CA 92093, USA
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21
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Ferretti MT, Martinkova J, Biskup E, Benke T, Gialdini G, Nedelska Z, Rauen K, Mantua V, Religa D, Hort J, Santuccione Chadha A, Schmidt R. Sex and gender differences in Alzheimer's disease: current challenges and implications for clinical practice: Position paper of the Dementia and Cognitive Disorders Panel of the European Academy of Neurology. Eur J Neurol 2020; 27:928-943. [PMID: 32056347 DOI: 10.1111/ene.14174] [Citation(s) in RCA: 66] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Accepted: 02/11/2020] [Indexed: 12/13/2022]
Abstract
Alzheimer's disease (AD) is characterized by high heterogeneity in disease manifestation, progression and risk factors. High phenotypic variability is currently regarded as one of the largest hurdles in early diagnosis and in the design of clinical trials; there is therefore great interest in identifying factors driving variability that can be used for patient stratification. In addition to genetic and lifestyle factors, the individual's sex and gender are emerging as crucial drivers of phenotypic variability. Evidence exists on sex and gender differences in the rate of cognitive deterioration and brain atrophy, and in the effect of risk factors as well as in the patterns of diagnostic biomarkers. Such evidence might be of high relevance and requires attention in clinical practice and clinical trials. However, sex and gender differences are currently seldom appreciated; importantly, consideration of sex and gender differences is not currently a focus in the design and analysis of clinical trials for AD. The objective of this position paper is (i) to provide an overview of known sex and gender differences that might have implications for clinical practice, (ii) to identify the most important knowledge gaps in the field (with a special regard to clinical trials) and (iii) to provide conclusions for future studies. This scientific statement is endorsed by the European Academy of Neurology.
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Affiliation(s)
- M T Ferretti
- Institute for Regenerative Medicine - IREM, University of Zurich, Zurich, Switzerland.,Women's Brain Project, Guntershausen, Switzerland
| | - J Martinkova
- Memory Clinic, Department of Neurology, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
| | - E Biskup
- College of Fundamental Medicine, Shanghai University of Medicine and Health Sciences, Shanghai, China.,Division of Internal Medicine, University Hospital of Basel, Basel, Switzerland
| | - T Benke
- Neurology Clinic, Medical University Innsbruck, Innsbruck, Austria
| | - G Gialdini
- Neurology - Private Practice, Lucca, Italy
| | - Z Nedelska
- Memory Clinic, Department of Neurology, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic.,International Clinical Research Center, St Anne's University Hospital Brno, Brno, Czech Republic
| | - K Rauen
- Institute for Regenerative Medicine - IREM, University of Zurich, Zurich, Switzerland.,Women's Brain Project, Guntershausen, Switzerland.,Department of Geriatric Psychiatry, University Hospital of Psychiatry Zurich, Zurich, Switzerland
| | - V Mantua
- Italian Medicines Agency, Rome, Italy
| | - D Religa
- Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Stockholm, Sweden
| | - J Hort
- Memory Clinic, Department of Neurology, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic.,International Clinical Research Center, St Anne's University Hospital Brno, Brno, Czech Republic
| | - A Santuccione Chadha
- Women's Brain Project, Guntershausen, Switzerland.,Global Medical and Scientific Affairs, Roche Diagnostics International Ltd, Rotkreuz, Switzerland
| | - R Schmidt
- Department of Neurogeriatrics, University Clinic of Neurology, Medical University Graz, Graz, Austria
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22
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Structured Cognitive Training Yields Best Results in Healthy Older Adults, and Their ApoE4 State and Baseline Cognitive Level Predict Training Benefits. Cogn Behav Neurol 2020; 32:76-86. [PMID: 31205121 DOI: 10.1097/wnn.0000000000000195] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Cognitive training has been shown to improve cognitive functions in healthy older adults. However, little is known about which specific variables are responsible for the improvement. OBJECTIVE Our aim was to evaluate whether healthy older adults benefit more from a structured cognitive training program than an unstructured brain jogging program and to identify possible predictors for training success, including apolipoprotein E4 (apoE4). METHODS In a randomized controlled trial, participants completed either a 6-week structured cognitive training program (n=35) or a 6-week unstructured brain jogging program (n=35). A control group received no training and was not part of the randomization procedure (n=35). Overall, 105 participants were included in the training data analyses, focusing on verbal memory, attention, and executive functions. Data from an additional 45 previously trained, healthy older adults were used for the predictor analysis. RESULTS A significant Time×Training interaction in favor of the structured cognitive training program was found in verbal memory. Low baseline performance on neuropsychological tests was a significant predictor for benefits in verbal memory, attention, and executive functions. A subgroup analysis (n=35) revealed that only noncarriers of the apoE4 allele showed significant gains in long-term verbal memory and attention. CONCLUSIONS Our results support the greater effectiveness of structured cognitive training on verbal memory compared with brain jogging and no training. The success of this type of training program may be predicted by sociodemographic, cognitive, and genetic variables.
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Giatti S, Diviccaro S, Serafini MM, Caruso D, Garcia-Segura LM, Viviani B, Melcangi RC. Sex differences in steroid levels and steroidogenesis in the nervous system: Physiopathological role. Front Neuroendocrinol 2020; 56:100804. [PMID: 31689419 DOI: 10.1016/j.yfrne.2019.100804] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 10/10/2019] [Accepted: 10/30/2019] [Indexed: 12/13/2022]
Abstract
The nervous system, in addition to be a target for steroid hormones, is the source of a variety of neuroactive steroids, which are synthesized and metabolized by neurons and glial cells. Recent evidence indicates that the expression of neurosteroidogenic proteins and enzymes and the levels of neuroactive steroids are different in the nervous system of males and females. We here summarized the state of the art of neuroactive steroids, particularly taking in consideration sex differences occurring in the synthesis and levels of these molecules. In addition, we discuss the consequences of sex differences in neurosteroidogenesis for the function of the nervous system under healthy and pathological conditions and the implications of neuroactive steroids and neurosteroidogenesis for the development of sex-specific therapeutic interventions.
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Affiliation(s)
- Silvia Giatti
- Dipartimento di Scienze Farmacologiche e Biomolecolari, Università degli Studi di Milano, Milano, Italy
| | - Silvia Diviccaro
- Dipartimento di Scienze Farmacologiche e Biomolecolari, Università degli Studi di Milano, Milano, Italy
| | - Melania Maria Serafini
- Dipartimento di Scienze Farmacologiche e Biomolecolari, Università degli Studi di Milano, Milano, Italy
| | - Donatella Caruso
- Dipartimento di Scienze Farmacologiche e Biomolecolari, Università degli Studi di Milano, Milano, Italy
| | - Luis Miguel Garcia-Segura
- Instituto Cajal, Consejo Superior de Investigaciones Científicas (CSIC), Madrid, Spain; Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain
| | - Barbara Viviani
- Dipartimento di Scienze Farmacologiche e Biomolecolari, Università degli Studi di Milano, Milano, Italy
| | - Roberto C Melcangi
- Dipartimento di Scienze Farmacologiche e Biomolecolari, Università degli Studi di Milano, Milano, Italy.
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Lecei A, van Winkel R. Hippocampal pattern separation of emotional information determining risk or resilience in individuals exposed to childhood trauma: Linking exposure to neurodevelopmental alterations and threat anticipation. Neurosci Biobehav Rev 2020; 108:160-170. [DOI: 10.1016/j.neubiorev.2019.11.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 11/15/2019] [Accepted: 11/15/2019] [Indexed: 12/29/2022]
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Sundermann EE, Maki P, Biegon A, Lipton RB, Mielke MM, Machulda M, Bondi MW. Sex-specific norms for verbal memory tests may improve diagnostic accuracy of amnestic MCI. Neurology 2019; 93:e1881-e1889. [PMID: 31597708 DOI: 10.1212/wnl.0000000000008467] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Accepted: 06/05/2019] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE To examine whether the use of sex-specific norms and cut scores to identify memory impairment improves diagnostic accuracy of amnestic mild cognitive impairment (aMCI) compared to non-sex-specific (typical) norms/cut scores given the female advantage in verbal memory. METHODS We calculated sex-specific and typical norms/cut scores (age and education specific) for impairment on the Rey Auditory Verbal Learning Test in the Mayo Clinic Study of Aging. Norms/cut scores were applied to 453 women and 532 men from the Alzheimer's Disease Neuroimaging Initiative. We compared sex differences in rates of aMCI (Jak/Bondi criteria) for sex-specific vs typical norms/cut scores. Using sex-specific cut scores as the true condition and typical cut scores as the predicted condition, we categorized participants as true positives (TPs), false positives (FPs), true negative (TNs), or false negative (FNs). In cross-sectional analyses within sex, we compared positivity rates of CSF hyperphosphorylated tau/β-amyloid (Aβ) and cortical Aβ deposition ([18F]AV45 PET) and APOE ε4 frequency among diagnostic comparison groups. RESULTS The frequency of aMCI was higher in men when using typical norms/cut scores. Using sex-adjusted norms/cut scores led to the identification of 10% FNs (missed aMCI cases) among women and 10% FPs among men. Biomarker analyses supported the hypothesis that sex-specific diagnostic criteria improves diagnostic accuracy. Biomarkers rates were higher in FNs vs TNs and similar in FNs and TPs. Biomarker rates were lower in FPs vs TPs and similar between FPs and TNs. CONCLUSION Results suggest that non-sex-specific aMCI diagnostic criteria led to a 20% diagnostic error rate. Accounting for sex differences in verbal memory performance may improve aMCI classification.
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Affiliation(s)
- Erin E Sundermann
- From the Department of Psychiatry (E.E.S., M.W.B.), University of California, San Diego; Departments of Psychiatry, Psychology, and Obstetrics & Gynecology (P.M.), University of Illinois at Chicago; Department of Radiology and Neurology (A.B.), State University of New York, Stony Brook; Einstein Aging Study and Department of Neurology (R.B.L.), Albert Einstein College of Medicine, Bronx, NY; Departments of Health Sciences Research and Neurology (M.M.M.) and Departments of Psychiatry and Psychology (M.M.), Mayo Clinic, Rochester, MN; and Veterans Affairs San Diego Healthcare System (M.W.B.), CA.
| | - Pauline Maki
- From the Department of Psychiatry (E.E.S., M.W.B.), University of California, San Diego; Departments of Psychiatry, Psychology, and Obstetrics & Gynecology (P.M.), University of Illinois at Chicago; Department of Radiology and Neurology (A.B.), State University of New York, Stony Brook; Einstein Aging Study and Department of Neurology (R.B.L.), Albert Einstein College of Medicine, Bronx, NY; Departments of Health Sciences Research and Neurology (M.M.M.) and Departments of Psychiatry and Psychology (M.M.), Mayo Clinic, Rochester, MN; and Veterans Affairs San Diego Healthcare System (M.W.B.), CA
| | - Anat Biegon
- From the Department of Psychiatry (E.E.S., M.W.B.), University of California, San Diego; Departments of Psychiatry, Psychology, and Obstetrics & Gynecology (P.M.), University of Illinois at Chicago; Department of Radiology and Neurology (A.B.), State University of New York, Stony Brook; Einstein Aging Study and Department of Neurology (R.B.L.), Albert Einstein College of Medicine, Bronx, NY; Departments of Health Sciences Research and Neurology (M.M.M.) and Departments of Psychiatry and Psychology (M.M.), Mayo Clinic, Rochester, MN; and Veterans Affairs San Diego Healthcare System (M.W.B.), CA
| | - Richard B Lipton
- From the Department of Psychiatry (E.E.S., M.W.B.), University of California, San Diego; Departments of Psychiatry, Psychology, and Obstetrics & Gynecology (P.M.), University of Illinois at Chicago; Department of Radiology and Neurology (A.B.), State University of New York, Stony Brook; Einstein Aging Study and Department of Neurology (R.B.L.), Albert Einstein College of Medicine, Bronx, NY; Departments of Health Sciences Research and Neurology (M.M.M.) and Departments of Psychiatry and Psychology (M.M.), Mayo Clinic, Rochester, MN; and Veterans Affairs San Diego Healthcare System (M.W.B.), CA
| | - Michelle M Mielke
- From the Department of Psychiatry (E.E.S., M.W.B.), University of California, San Diego; Departments of Psychiatry, Psychology, and Obstetrics & Gynecology (P.M.), University of Illinois at Chicago; Department of Radiology and Neurology (A.B.), State University of New York, Stony Brook; Einstein Aging Study and Department of Neurology (R.B.L.), Albert Einstein College of Medicine, Bronx, NY; Departments of Health Sciences Research and Neurology (M.M.M.) and Departments of Psychiatry and Psychology (M.M.), Mayo Clinic, Rochester, MN; and Veterans Affairs San Diego Healthcare System (M.W.B.), CA
| | - Mary Machulda
- From the Department of Psychiatry (E.E.S., M.W.B.), University of California, San Diego; Departments of Psychiatry, Psychology, and Obstetrics & Gynecology (P.M.), University of Illinois at Chicago; Department of Radiology and Neurology (A.B.), State University of New York, Stony Brook; Einstein Aging Study and Department of Neurology (R.B.L.), Albert Einstein College of Medicine, Bronx, NY; Departments of Health Sciences Research and Neurology (M.M.M.) and Departments of Psychiatry and Psychology (M.M.), Mayo Clinic, Rochester, MN; and Veterans Affairs San Diego Healthcare System (M.W.B.), CA
| | - Mark W Bondi
- From the Department of Psychiatry (E.E.S., M.W.B.), University of California, San Diego; Departments of Psychiatry, Psychology, and Obstetrics & Gynecology (P.M.), University of Illinois at Chicago; Department of Radiology and Neurology (A.B.), State University of New York, Stony Brook; Einstein Aging Study and Department of Neurology (R.B.L.), Albert Einstein College of Medicine, Bronx, NY; Departments of Health Sciences Research and Neurology (M.M.M.) and Departments of Psychiatry and Psychology (M.M.), Mayo Clinic, Rochester, MN; and Veterans Affairs San Diego Healthcare System (M.W.B.), CA
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Hillerer KM, Slattery DA, Pletzer B. Neurobiological mechanisms underlying sex-related differences in stress-related disorders: Effects of neuroactive steroids on the hippocampus. Front Neuroendocrinol 2019; 55:100796. [PMID: 31580837 PMCID: PMC7115954 DOI: 10.1016/j.yfrne.2019.100796] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 09/26/2019] [Accepted: 09/27/2019] [Indexed: 12/19/2022]
Abstract
Men and women differ in their vulnerability to a variety of stress-related illnesses, but the underlying neurobiological mechanisms are not well understood. This is likely due to a comparative dearth of neurobiological studies that assess male and female rodents at the same time, while human neuroimaging studies often don't model sex as a variable of interest. These sex differences are often attributed to the actions of sex hormones, i.e. estrogens, progestogens and androgens. In this review, we summarize the results on sex hormone actions in the hippocampus and seek to bridge the gap between animal models and findings in humans. However, while effects of sex hormones on the hippocampus are largely consistent in animals and humans, methodological differences challenge the comparability of animal and human studies on stress effects. We summarise our current understanding of the neurobiological mechanisms that underlie sex-related differences in behavior and discuss implications for stress-related illnesses.
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Affiliation(s)
- Katharina M Hillerer
- Department of Obstetrics and Gynaecology, Salzburger Landeskrankenhaus (SALK), Paracelsus Medical University (PMU), Clinical Research Center Salzburg (CRCS), Salzburg, Austria.
| | - David A Slattery
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University, Frankfurt, Germany
| | - Belinda Pletzer
- Department of Psychology, University of Salzburg, Salzburg, Austria; Centre for Cognitive Neuroscience, University of Salzburg, Salzburg, Austria
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27
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Ullah MF, Ahmad A, Bhat SH, Abu-Duhier FM, Barreto GE, Ashraf GM. Impact of sex differences and gender specificity on behavioral characteristics and pathophysiology of neurodegenerative disorders. Neurosci Biobehav Rev 2019; 102:95-105. [DOI: 10.1016/j.neubiorev.2019.04.003] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2018] [Revised: 01/24/2019] [Accepted: 04/04/2019] [Indexed: 01/06/2023]
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Wang X, Wang Y, Hu Y, Wang L, Zhao W, Wei L, Chen H, Han F. Effect of flurbiprofen axetil on postoperative delirium for elderly patients. Brain Behav 2019; 9:e01290. [PMID: 31007001 PMCID: PMC6576198 DOI: 10.1002/brb3.1290] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Revised: 03/20/2019] [Accepted: 03/26/2019] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVES Proinflammatory cytokines triggered by surgery and postoperative pain are major causes of postoperative delirium (POD). This study investigated the effects of flurbiprofen axetil on POD when used for postoperative analgesia after major noncardiac surgery in elderly patients. METHODS Patients over 65 years old were randomly divided into two groups: the sufentanil group (S group), in which 150 μg of sufentanil was used in the patient-controlled analgesia (PCA) pump for 3 days; the sufentanil combined with flurbiprofen axetil group (SF group), in which 150 μg of sufentanil was combined with 300 mg of flurbiprofen axetil in the PCA pump for 3 days. The Confusion Assessment Method scale was used for POD evaluation. The pain intensity, side effects, and risk factors (age, gender, surgical position, and category of surgery) for POD were evaluated. RESULTS Ultimately, 140 patients were included. The overall incidence of POD was not significantly different between the S and SF groups. The incidence of POD was significantly lower in the SF group than in the S group among patients over 70 years (5.1% vs. 20.7%, p = 0.045, odds ratio = 0.146, 95% confidence interval = 0.020-1.041). The incidence of POD was no difference in patients classified by the category of surgery, surgical position, or gender between groups. Sufentanil and flurbiprofen axetil in the PCA pump was completely used within 72 hr. The pain intensity, consumed sufentanil dosage of the PCA, and the side effects was not different between groups. CONCLUSIONS Flurbiprofen axetil might reduce POD in patients over 70 years undergoing major noncardiac surgery.
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Affiliation(s)
- Xifan Wang
- Department of Anesthesiology, The Third Affiliated Hospital, Harbin Medical University, Harbin, Heilongjiang, China
| | - Yu Wang
- Department of Anesthesiology, The Third Affiliated Hospital, Harbin Medical University, Harbin, Heilongjiang, China
| | - Yanan Hu
- Department of Anesthesiology, The Third Affiliated Hospital, Harbin Medical University, Harbin, Heilongjiang, China
| | - Liping Wang
- Department of Anesthesiology, The Third Affiliated Hospital, Harbin Medical University, Harbin, Heilongjiang, China
| | - Wenshuai Zhao
- Department of Anesthesiology, The Third Affiliated Hospital, Harbin Medical University, Harbin, Heilongjiang, China
| | - Lanying Wei
- Department of Anesthesiology, The Third Affiliated Hospital, Harbin Medical University, Harbin, Heilongjiang, China
| | - Hong Chen
- Department of Anesthesiology, The Third Affiliated Hospital, Harbin Medical University, Harbin, Heilongjiang, China
| | - Fei Han
- Department of Anesthesiology, The Third Affiliated Hospital, Harbin Medical University, Harbin, Heilongjiang, China
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Roheger M, Meyer J, Kessler J, Kalbe E. Predicting short- and long-term cognitive training success in healthy older adults: who benefits? AGING NEUROPSYCHOLOGY AND COGNITION 2019; 27:351-369. [DOI: 10.1080/13825585.2019.1617396] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Mandy Roheger
- Department of Medical Psychology, Neuropsychology and Gender Studies & Center for Neuropsychological Diagnostics and Intervention (CeNDI), Medical Faculty and University Hospital of Cologne, Cologne, Germany
| | - Julia Meyer
- Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm), University of Osnabrueck, Osnabrueck, Germany
| | - Josef Kessler
- Department of Neurology, University Hospital Cologne, Cologne, Germany
| | - Elke Kalbe
- Department of Medical Psychology, Neuropsychology and Gender Studies & Center for Neuropsychological Diagnostics and Intervention (CeNDI), Medical Faculty and University Hospital of Cologne, Cologne, Germany
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Navarro E, Calero MD. Cognitive Plasticity in Young-Old Adults and Old-Old Adults and Its Relationship with Successful Aging. Geriatrics (Basel) 2018; 3:geriatrics3040076. [PMID: 31011111 PMCID: PMC6371126 DOI: 10.3390/geriatrics3040076] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Revised: 10/24/2018] [Accepted: 10/26/2018] [Indexed: 11/22/2022] Open
Abstract
The general objective of this study was to analyze cognitive plasticity as a variable related to successful aging in a group of young-old adults and old-old adults using the Auditory Verbal Learning Test—Learning Potential (AVLT-LP). Method: A total of 569 persons, with mean age 76.67 years (379 between the ages of 65 and 80 years, and 190 older than age 80). They were assessed with a socio-health questionnaire, with the AVLT-LP, and with the Spanish version of the Mini Mental State Examination. Results: The results showed significant differences on the test, in favor of the younger group, while the over 80 group gave poorer performance and showed less cognitive plasticity. With relation to gender, slight differences appeared in favor of the women, on the first four test trials, but not on the last two, nor in delayed recall or cognitive plasticity. As for cognitive status, the results showed significantly better task performance levels in healthy elders, as well as greater plasticity. Nonetheless, certain persons with high plasticity were also found among those with cognitive impairment. Conclusions: The data obtained here offers evidence for the importance of cognitive plasticity in elders and its relation to longevity and successful aging. It also provides information about the influence of variables like age, gender and cognitive status on a verbal memory and plasticity assessment task that is in wide use today.
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Affiliation(s)
- Elena Navarro
- Department of Personality, Psychological Assessment and Treatment, Faculty of Psychology, University of Granada, 18071 Granada, Spain.
| | - M Dolores Calero
- CIMCYC, Research Center on Mind, Brain and Behavior, University of Granada, 18071 Granada, Spain.
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Yang K, Shen B, Li DK, Wang Y, Zhao J, Zhao J, Yu WB, Liu ZY, Tang YL, Liu FT, Yu H, Wang J, Guo QH, Wu JJ. Cognitive characteristics in Chinese non-demented PD patients based on gender difference. Transl Neurodegener 2018; 7:16. [PMID: 30038782 PMCID: PMC6052700 DOI: 10.1186/s40035-018-0120-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Accepted: 06/26/2018] [Indexed: 01/19/2023] Open
Abstract
Background Cognitive impairment is one of the non-motor symptoms in Parkinson’s disease (PD). In the present study, we aim to examine the cognitive function of non-demented Parkinson’s disease patients and compare the results between male and female patients as well as control groups in search of any gender effect. Methods Sixty PD Patients (30 males and 30 females) from the Movement Disorders Clinic at Huashan Hospital Affiliated to Fudan University were recruited to participate in the study. One hundred age and gender matched control subjects without neurological or psychiatric disorders were voluntarily recruited. The participants were administered measures of cognition in five domains including memory, language, spatial processing abilities, attention and executive function. Results PD patients attained significantly lower scores in the visual spatial function, language and attention/executive function compared with the control group. Anti-parkinsonian treated patients performed worse in Rey-copy score, Clock Drawing Test (CDT) and Verbal Fluency-City than untreated ones. In regard to gender differences, though no general cognitive differences were found in Mini-mental State Examination (MMSE), men surpassed women on Boston naming test (BNT) while women were superior on Auditory Verbal Learning Test-long (AVLT) delayed cued recall test. Conclusions Cognitive impairments were common in PD patients even in the absence of dementia. PD patients with anti-parkinsonian medication had worse cognitive impairment than untreated patients. Genders may have different manifestations of cognitive impairment in PD patients.
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Affiliation(s)
- Ke Yang
- 1Department of Neurology and Institute of Neurology, Huashan Hospital, Fudan University, 12 Wulumuqi Zhong Road, Shanghai, 200040 China
| | - Bo Shen
- 1Department of Neurology and Institute of Neurology, Huashan Hospital, Fudan University, 12 Wulumuqi Zhong Road, Shanghai, 200040 China
| | - Da-Ke Li
- 1Department of Neurology and Institute of Neurology, Huashan Hospital, Fudan University, 12 Wulumuqi Zhong Road, Shanghai, 200040 China
| | - Ying Wang
- 1Department of Neurology and Institute of Neurology, Huashan Hospital, Fudan University, 12 Wulumuqi Zhong Road, Shanghai, 200040 China
| | - Jue Zhao
- 1Department of Neurology and Institute of Neurology, Huashan Hospital, Fudan University, 12 Wulumuqi Zhong Road, Shanghai, 200040 China
| | - Jian Zhao
- 1Department of Neurology and Institute of Neurology, Huashan Hospital, Fudan University, 12 Wulumuqi Zhong Road, Shanghai, 200040 China
| | - Wen-Bo Yu
- 1Department of Neurology and Institute of Neurology, Huashan Hospital, Fudan University, 12 Wulumuqi Zhong Road, Shanghai, 200040 China
| | - Zhen-Yang Liu
- 1Department of Neurology and Institute of Neurology, Huashan Hospital, Fudan University, 12 Wulumuqi Zhong Road, Shanghai, 200040 China
| | - Yi-Lin Tang
- 1Department of Neurology and Institute of Neurology, Huashan Hospital, Fudan University, 12 Wulumuqi Zhong Road, Shanghai, 200040 China
| | - Feng-Tao Liu
- 1Department of Neurology and Institute of Neurology, Huashan Hospital, Fudan University, 12 Wulumuqi Zhong Road, Shanghai, 200040 China
| | - Huan Yu
- 1Department of Neurology and Institute of Neurology, Huashan Hospital, Fudan University, 12 Wulumuqi Zhong Road, Shanghai, 200040 China
| | - Jian Wang
- 1Department of Neurology and Institute of Neurology, Huashan Hospital, Fudan University, 12 Wulumuqi Zhong Road, Shanghai, 200040 China
| | - Qi-Hao Guo
- 1Department of Neurology and Institute of Neurology, Huashan Hospital, Fudan University, 12 Wulumuqi Zhong Road, Shanghai, 200040 China
| | - Jian-Jun Wu
- 1Department of Neurology and Institute of Neurology, Huashan Hospital, Fudan University, 12 Wulumuqi Zhong Road, Shanghai, 200040 China.,Department of Neurology, Jing'an District Center Hospital of Shanghai, 259 Xikang Road, Shanghai, 20040 China
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Geary DC. Evolutionary perspective on sex differences in the expression of neurological diseases. Prog Neurobiol 2018; 176:33-53. [PMID: 29890214 DOI: 10.1016/j.pneurobio.2018.06.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Revised: 04/25/2018] [Accepted: 06/05/2018] [Indexed: 12/20/2022]
Abstract
Sex-specific brain and cognitive deficits emerge with malnutrition, some infectious and neurodegenerative diseases, and often with prenatal or postnatal toxin exposure. These deficits are described in disparate literatures and are generally not linked to one another. Sexual selection may provide a unifying framework that integrates our understanding of these deficits and provides direction for future studies of sex-specific vulnerabilities. Sexually selected traits are those that have evolved to facilitate competition for reproductive resources or that influence mate choices, and are often larger and more complex than other traits. Critically, malnutrition, disease, chronic social stress, and exposure to man-made toxins compromise the development and expression of sexually selected traits more strongly than that of other traits. The fundamental mechanism underlying vulnerability might be the efficiency of mitochondrial energy capture and control of oxidative stress that in turn links these traits to current advances in neuroenergetics, stress endocrinology, and toxicology. The key idea is that the elaboration of these cognitive abilities, with more underlying gray matter or more extensive inter-modular white matter connections, makes them particularly sensitive to disruptions in mitochondrial functioning and oxidative stress. A framework of human sexually selected cognitive abilities and underlying brain systems is proposed and used to organize what is currently known about sex-specific vulnerabilities.
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Affiliation(s)
- David C Geary
- Department of Psychological Sciences, Interdisciplinary Neuroscience, University of Missouri, MO, 65211-2500, Columbia, United States.
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Sejunaite K, Lanza C, Riepe MW. Everyday false memories in older persons with depressive disorder. Psychiatry Res 2018; 261:456-463. [PMID: 29407717 DOI: 10.1016/j.psychres.2018.01.030] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Revised: 01/12/2018] [Accepted: 01/14/2018] [Indexed: 11/26/2022]
Abstract
Generally we tend to think that memory in daily living is complete and accurate in healthy persons. However, current memory research has revealed inconspicuous memory faults. Rarely omissions and distortions of memory are researched with tasks resembling everyday life. We investigated healthy older control subjects (HC) and patients with depressive disorder (DD). Cognitive function was assessed with a comprehensive neuropsychological test battery and mood with the Montgomery-Asberg Depression Scale (MADRS). We assessed everyday veridical and distorted memories on showing participants original news and commercials. In most aspects of attention, executive functions, and memory, patients with DD performed worse than HC. Regarding memory content on viewing news or commercials the difference between patients with DD and HC was more pronounced for false memory content than for veridical memory content. Linear regression analysis showed the extent of false memory content being associated with mental flexibility as assessed with the Trail Making Test and mood as assessed with the MADRS for both information obtained on viewing news and commercials. Increase of false memories impedes overall accuracy of memory more than decrease of veridical memories in older persons with depressive disorder. Diminished executive functions and depressive mood partly explain these memory distortions.
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Affiliation(s)
- Karolina Sejunaite
- Department of Psychiatry and Psychotherapy II, Mental Health & Old Age Psychiatry, Ulm University, Ulm, Germany.
| | - Claudia Lanza
- Department of Psychiatry and Psychotherapy II, Mental Health & Old Age Psychiatry, Ulm University, Ulm, Germany.
| | - Matthias W Riepe
- Department of Psychiatry and Psychotherapy II, Mental Health & Old Age Psychiatry, Ulm University, Ulm, Germany.
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Sundermann EE, Biegon A, Rubin LH, Lipton RB, Landau S, Maki PM. Does the Female Advantage in Verbal Memory Contribute to Underestimating Alzheimer's Disease Pathology in Women versus Men? J Alzheimers Dis 2018; 56:947-957. [PMID: 28106548 DOI: 10.3233/jad-160716] [Citation(s) in RCA: 96] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
There is a growing recognition of sex differences in Alzheimer's disease (AD). Females show an advantage over males on tests of verbal memory, which are used to diagnose AD and its precursor, amnestic mild cognitive impairment (aMCI). Women retain this advantage in aMCI despite reduced hippocampal volume and temporal lobe glucose metabolism. Here we examined whether this female advantage endures despite evidence of AD-specific pathology, cortical amyloid-β (Aβ) deposition measured with [18F]AV45 (florbetapir) positron emission tomography. Participants with normal cognition (N = 304), aMCI (N = 515), and AD dementia (N = 175) were drawn from the Alzheimer's Disease Neuroimaging Initiative (ADNI). Across and within diagnostic groups, we conducted linear regressions to examine the interaction of sex with cortical Aβ burden on immediate and delayed recall on the Rey Auditory Verbal Learning Test (RAVLT) adjusting for age, education, and APOE4. In the overall group, sex by cortical Aβ interaction was significant for delayed recall only. Overall, delayed recall performance was significantly better in women versus men among those with low to moderate Aβ burden, but women and men performed similarly among those with high Aβ burden. In diagnosis-stratified analyses, a significant sex by cortical Aβ interaction was observed for delayed recall in the aMCI group, but not in the normal or AD dementia groups. Thus, women maintain a verbal memory advantage over men in aMCI despite similar levels of AD pathology. Although this advantage may benefit women by delaying verbal memory impairment until more advanced pathology, it may also delay diagnosis of aMCI and treatment intervention.
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Affiliation(s)
- Erin E Sundermann
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - Anat Biegon
- Department of Neurology, State University of New York, New York, NY, USA
| | - Leah H Rubin
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA
| | - Richard B Lipton
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - Susan Landau
- Einstein Aging Study and the Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Pauline M Maki
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA
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Kalbe E, Bintener C, Ophey A, Reuter C, Göbel S, Klöters S, Baller G, Kessler J. Computerized Cognitive Training in Healthy Older Adults: Baseline Cognitive Level and Subjective Cognitive Concerns Predict Training Outcome. Health (London) 2018. [DOI: 10.4236/health.2018.101003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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36
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Geary DC. Evolution of Human Sex-Specific Cognitive Vulnerabilities. QUARTERLY REVIEW OF BIOLOGY 2017. [DOI: 10.1086/694934] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Elosúa MR, Ciudad MJ, Contreras MJ. Gender Differences in Verbal and Visuospatial Working Memory Tasks in Patients with Mild Cognitive Impairment and Alzheimer Disease. Dement Geriatr Cogn Dis Extra 2017; 7:101-108. [PMID: 28553312 PMCID: PMC5425757 DOI: 10.1159/000466689] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Accepted: 02/27/2017] [Indexed: 12/26/2022] Open
Abstract
Background/Aims To date, there are few studies on gender differences in patients with mild cognitive impairment (MCI) and Alzheimer disease (AD). In the present study, the existence of differences between sexes in verbal and visuospatial working memory tasks in the evolution of cognitive and pathological aging was examined. Method Ninety participants took part in this study: 30 AD, 30 MCI, and 30 healthy elderly participants (50% men and 50% women). Results There were no significant differences between men and women with AD in visuospatial tasks, whereas these differences were found within the MCI group, with the average of men achieving significantly higher results than women. In verbal tasks, there were no differences between sexes for any of the groups. Conclusion Execution in visuospatial tasks tends to depend on gender, whereas this does not occur for verbal tasks.
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Affiliation(s)
- M Rosa Elosúa
- Universidad Nacional de Educación a Distancia (UNED), Madrid, Spain
| | - María José Ciudad
- Universidad Nacional de Educación a Distancia (UNED), Madrid, Spain.,Geriatrics and Palliative Care, Badalona Serveis Assistencials, Badalona, Spain
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Yagi S, Drewczynski D, Wainwright SR, Barha CK, Hershorn O, Galea LAM. Sex and estrous cycle differences in immediate early gene activation in the hippocampus and the dorsal striatum after the cue competition task. Horm Behav 2017; 87:69-79. [PMID: 27984032 DOI: 10.1016/j.yhbeh.2016.10.019] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Revised: 09/29/2016] [Accepted: 10/28/2016] [Indexed: 12/28/2022]
Abstract
The hippocampus and dorsal striatum are important structures involved in place and response learning strategies respectively. Both sex and estrous cycle phase differences in learning strategy preference exist following cue competition paradigms. Furthermore, significant effects of sex and learning strategy on hippocampal neural plasticity have been reported. However, associations between learning strategy and immediate early gene (IEG) expression in the hippocampus and dorsal striatum are not completely understood. In the current study we investigated the effects of sex and estrous cycle phase on strategy choice and IEG expression in the hippocampus and dorsal striatum of rats following cue competition training in the Morris water maze. We found that proestrous rats were more likely to choose a place strategy than non-proestrous or male rats. Although male cue strategy users travelled greater distances than the other groups on the first day of training, there were no other sex or strategy differences in the ability to reach a hidden or a visible platform. Female place strategy users exhibited greater zif268 expression and male place strategy users exhibited greater cFos expression compared to all other groups in CA3. Furthermore, cue strategy users had greater expression of cFos in the dorsal striatum than place strategy users. Shorter distances to reach a visible platform were associated with less activation of cFos in CA3 and CA1 of male place strategy users. Our findings indicate multiple differences in brain activation with sex and strategy use, despite limited behavioral differences between the sexes on this cue competition paradigm.
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Affiliation(s)
- Shunya Yagi
- Graduate Program in Neuroscience, University of British Columbia, Vancouver, Canada
| | - Dimka Drewczynski
- Department of Psychology, University of British Columbia, Vancouver, Canada
| | - Steven R Wainwright
- Graduate Program in Neuroscience, University of British Columbia, Vancouver, Canada
| | - Cindy K Barha
- Department of Psychology, University of British Columbia, Vancouver, Canada
| | - Olivia Hershorn
- Department of Psychology, University of British Columbia, Vancouver, Canada
| | - Liisa A M Galea
- Graduate Program in Neuroscience, University of British Columbia, Vancouver, Canada; Department of Psychology, University of British Columbia, Vancouver, Canada; Centre for Brain Health, University of British Columbia, Vancouver, Canada.
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Sundermann EE, Maki PM, Rubin LH, Lipton RB, Landau S, Biegon A. Female advantage in verbal memory: Evidence of sex-specific cognitive reserve. Neurology 2016; 87:1916-1924. [PMID: 27708128 DOI: 10.1212/wnl.0000000000003288] [Citation(s) in RCA: 144] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Accepted: 07/14/2016] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE We investigated sex differences in verbal memory across different levels of neural dysfunction, measured by temporal lobe glucose metabolic rates (TLGluMR). METHODS Three hundred ninety controls and 672 participants with amnestic mild cognitive impairment (aMCI) and 254 with Alzheimer disease (AD) dementia from the Alzheimer's Disease Neuroimaging Initiative completed the Rey Auditory Verbal Learning Test (RAVLT) and [18F]-fluorodeoxyglucose-PET. Cross-sectional analyses were conducted using linear regression to examine the sex by TLGluMR interaction on RAVLT performance in the overall sample and within diagnostic groups adjusting for age, education, and APOE ε4 genotype. RESULTS Across groups, female sex and higher TLGluMR and their interaction were associated with better verbal memory (p values ≤ 0.005). The female advantage in verbal memory varied by TLGluMR such that the advantage was greatest among individuals with moderate to high TLGluMR and minimal or absent among individuals with lower TLGluMR. Diagnosis-stratified analyses revealed that this interaction was driven by the aMCI group (p values = 0.009). The interaction was not significant in control and AD dementia groups. CONCLUSIONS Women show better verbal memory than men in aMCI despite similar levels of brain hypometabolism. The lifelong advantage that females show over males in verbal memory might represent a form of cognitive reserve that delays verbal memory decline until more advanced pathology, as indexed by TLGluMR. This issue is clinically important because verbal memory scores are used in diagnosing aMCI and AD dementia.
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Affiliation(s)
- Erin E Sundermann
- From the Einstein Aging Study and the Department of Neurology (E.E.S., R.B.L.), Albert Einstein College of Medicine, Bronx, NY; Department of Psychiatry (P.M.M., L.H.R.), University of Illinois at Chicago; Helen Wills Neuroscience Institute (S.L.), University of California, Berkeley; and Department of Neurology (A.B.), State University of New York, Stony Brook.
| | - Pauline M Maki
- From the Einstein Aging Study and the Department of Neurology (E.E.S., R.B.L.), Albert Einstein College of Medicine, Bronx, NY; Department of Psychiatry (P.M.M., L.H.R.), University of Illinois at Chicago; Helen Wills Neuroscience Institute (S.L.), University of California, Berkeley; and Department of Neurology (A.B.), State University of New York, Stony Brook
| | - Leah H Rubin
- From the Einstein Aging Study and the Department of Neurology (E.E.S., R.B.L.), Albert Einstein College of Medicine, Bronx, NY; Department of Psychiatry (P.M.M., L.H.R.), University of Illinois at Chicago; Helen Wills Neuroscience Institute (S.L.), University of California, Berkeley; and Department of Neurology (A.B.), State University of New York, Stony Brook
| | - Richard B Lipton
- From the Einstein Aging Study and the Department of Neurology (E.E.S., R.B.L.), Albert Einstein College of Medicine, Bronx, NY; Department of Psychiatry (P.M.M., L.H.R.), University of Illinois at Chicago; Helen Wills Neuroscience Institute (S.L.), University of California, Berkeley; and Department of Neurology (A.B.), State University of New York, Stony Brook
| | - Susan Landau
- From the Einstein Aging Study and the Department of Neurology (E.E.S., R.B.L.), Albert Einstein College of Medicine, Bronx, NY; Department of Psychiatry (P.M.M., L.H.R.), University of Illinois at Chicago; Helen Wills Neuroscience Institute (S.L.), University of California, Berkeley; and Department of Neurology (A.B.), State University of New York, Stony Brook
| | - Anat Biegon
- From the Einstein Aging Study and the Department of Neurology (E.E.S., R.B.L.), Albert Einstein College of Medicine, Bronx, NY; Department of Psychiatry (P.M.M., L.H.R.), University of Illinois at Chicago; Helen Wills Neuroscience Institute (S.L.), University of California, Berkeley; and Department of Neurology (A.B.), State University of New York, Stony Brook
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Levels and actions of neuroactive steroids in the nervous system under physiological and pathological conditions: Sex-specific features. Neurosci Biobehav Rev 2016; 67:25-40. [DOI: 10.1016/j.neubiorev.2015.09.023] [Citation(s) in RCA: 66] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Revised: 09/15/2015] [Accepted: 09/16/2015] [Indexed: 01/21/2023]
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Laws KR, Irvine K, Gale TM. Sex differences in cognitive impairment in Alzheimer’s disease. World J Psychiatry 2016; 6:54-65. [PMID: 27014598 PMCID: PMC4804268 DOI: 10.5498/wjp.v6.i1.54] [Citation(s) in RCA: 186] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Revised: 11/14/2015] [Accepted: 01/22/2016] [Indexed: 02/05/2023] Open
Abstract
Sex differences in neurocognitive abilities have been extensively explored both in the healthy population and in many disorders. Until recently, however, little work has examined such differences in people with Alzheimer’s disease (AD). This is despite clear evidence that AD is more prevalent in women, and converging lines of evidence from brain imaging, post-mortem analyses, hormone therapy and genetics suggesting that AD affects men and women differently. We provide an overview of evidence attesting to the poorer cognitive profiles in women than in men at the same stage of AD. Indeed, men significantly outperform women in several cognitive domains, including: Language and semantic abilities, visuospatial abilities and episodic memory. These differences do not appear to be attributable to any differences in age, education, or dementia severity. Reasons posited for this female disadvantage include a reduction of estrogen in postmenopausal women, greater cognitive reserve in men, and the influence of the apolipoprotein E ε4 allele. Assessment of cognitive abilities contributes to the diagnosis of the condition and thus, it is crucial to identify the role of sex differences if potentially more accurate diagnoses and treatments are to emerge.
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Sundermann EE, Biegon A, Rubin LH, Lipton RB, Mowrey W, Landau S, Maki PM. Better verbal memory in women than men in MCI despite similar levels of hippocampal atrophy. Neurology 2016; 86:1368-1376. [PMID: 26984945 DOI: 10.1212/wnl.0000000000002570] [Citation(s) in RCA: 118] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Accepted: 10/26/2015] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To examine sex differences in the relationship between clinical symptoms related to Alzheimer disease (AD) (verbal memory deficits) and neurodegeneration (hippocampal volume/intracranial volume ratio [HpVR]) across AD stages. METHODS The sample included 379 healthy participants, 694 participants with amnestic mild cognitive impairment (aMCI), and 235 participants with AD and dementia from the Alzheimer's Disease Neuroimaging Initiative who completed the Rey Auditory Verbal Learning Test (RAVLT). Cross-sectional analyses were conducted using linear regression to examine the interaction between sex and HpVR on RAVLT across and within diagnostic groups adjusting for age, education, and APOE ε4 status. RESULTS Across groups, there were significant sex × HpVR interactions for immediate and delayed recall (p < 0.01). Women outperformed men among individuals with moderate to larger HpVR, but not among individuals with smaller HpVR. In diagnosis-stratified analyses, the HpVR × sex interaction was significant in the aMCI group, but not in the control or AD dementia groups, for immediate and delayed recall (p < 0.01). Among controls, women outperformed men on both outcomes irrespective of HpVR (p < 0.001). In AD dementia, better RAVLT performance was independently associated with female sex (immediate, p = 0.04) and larger HpVR (delayed, p = 0.001). CONCLUSION Women showed an advantage in verbal memory despite evidence of moderate hippocampal atrophy. This advantage may represent a sex-specific form of cognitive reserve delaying verbal memory decline until more advanced disease stages.
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Affiliation(s)
- Erin E Sundermann
- From the Einstein Aging Study and the Department of Neurology (E.E.S., R.B.L.) and the Department of Epidemiology and Population Health (W.M.), Albert Einstein College of Medicine, Bronx; Department of Neurology (A.B.), State University of New York, Stony Brook; Department of Psychiatry (L.H.R., P.M.M.), University of Illinois at Chicago; and Helen Wills Neuroscience Institute (S.L.), University of California, Berkeley.
| | - Anat Biegon
- From the Einstein Aging Study and the Department of Neurology (E.E.S., R.B.L.) and the Department of Epidemiology and Population Health (W.M.), Albert Einstein College of Medicine, Bronx; Department of Neurology (A.B.), State University of New York, Stony Brook; Department of Psychiatry (L.H.R., P.M.M.), University of Illinois at Chicago; and Helen Wills Neuroscience Institute (S.L.), University of California, Berkeley
| | - Leah H Rubin
- From the Einstein Aging Study and the Department of Neurology (E.E.S., R.B.L.) and the Department of Epidemiology and Population Health (W.M.), Albert Einstein College of Medicine, Bronx; Department of Neurology (A.B.), State University of New York, Stony Brook; Department of Psychiatry (L.H.R., P.M.M.), University of Illinois at Chicago; and Helen Wills Neuroscience Institute (S.L.), University of California, Berkeley
| | - Richard B Lipton
- From the Einstein Aging Study and the Department of Neurology (E.E.S., R.B.L.) and the Department of Epidemiology and Population Health (W.M.), Albert Einstein College of Medicine, Bronx; Department of Neurology (A.B.), State University of New York, Stony Brook; Department of Psychiatry (L.H.R., P.M.M.), University of Illinois at Chicago; and Helen Wills Neuroscience Institute (S.L.), University of California, Berkeley
| | - Wenzhu Mowrey
- From the Einstein Aging Study and the Department of Neurology (E.E.S., R.B.L.) and the Department of Epidemiology and Population Health (W.M.), Albert Einstein College of Medicine, Bronx; Department of Neurology (A.B.), State University of New York, Stony Brook; Department of Psychiatry (L.H.R., P.M.M.), University of Illinois at Chicago; and Helen Wills Neuroscience Institute (S.L.), University of California, Berkeley
| | - Susan Landau
- From the Einstein Aging Study and the Department of Neurology (E.E.S., R.B.L.) and the Department of Epidemiology and Population Health (W.M.), Albert Einstein College of Medicine, Bronx; Department of Neurology (A.B.), State University of New York, Stony Brook; Department of Psychiatry (L.H.R., P.M.M.), University of Illinois at Chicago; and Helen Wills Neuroscience Institute (S.L.), University of California, Berkeley
| | - Pauline M Maki
- From the Einstein Aging Study and the Department of Neurology (E.E.S., R.B.L.) and the Department of Epidemiology and Population Health (W.M.), Albert Einstein College of Medicine, Bronx; Department of Neurology (A.B.), State University of New York, Stony Brook; Department of Psychiatry (L.H.R., P.M.M.), University of Illinois at Chicago; and Helen Wills Neuroscience Institute (S.L.), University of California, Berkeley
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Yagi S, Chow C, Lieblich SE, Galea LAM. Sex and strategy use matters for pattern separation, adult neurogenesis, and immediate early gene expression in the hippocampus. Hippocampus 2015; 26:87-101. [PMID: 26179150 DOI: 10.1002/hipo.22493] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/06/2015] [Indexed: 12/12/2022]
Abstract
Adult neurogenesis in the dentate gyrus (DG) plays a crucial role for pattern separation, and there are sex differences in the regulation of neurogenesis. Although sex differences, favoring males, in spatial navigation have been reported, it is not known whether there are sex differences in pattern separation. The current study was designed to determine whether there are sex differences in the ability for separating similar or distinct patterns, learning strategy choice, adult neurogenesis, and immediate early gene (IEG) expression in the DG in response to pattern separation training. Male and female Sprague-Dawley rats received a single injection of the DNA synthesis marker, bromodeoxyuridine (BrdU), and were tested for the ability of separating spatial patterns in a spatial pattern separation version of delayed nonmatching to place task using the eight-arm radial arm maze. Twenty-seven days following BrdU injection, rats received a probe trial to determine whether they were idiothetic or spatial strategy users. We found that male spatial strategy users outperformed female spatial strategy users only when separating similar, but not distinct, patterns. Furthermore, male spatial strategy users had greater neurogenesis in response to pattern separation training than all other groups. Interestingly, neurogenesis was positively correlated with performance on similar pattern trials during pattern separation in female spatial strategy users but negatively correlated with performance in male idiothetic strategy users. These results suggest that the survival of new neurons may play an important positive role for pattern separation of similar patterns in females. Furthermore, we found sex and strategy differences in IEG expression in the CA1 and CA3 regions in response to pattern separation. These findings emphasize the importance of studying biological sex on hippocampal function and neural plasticity.
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Affiliation(s)
- Shunya Yagi
- Graduate Program in Neuroscience, University of British Columbia, Vancouver, British Columbia, Canada
| | - Carmen Chow
- Department of Psychology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Stephanie E Lieblich
- Department of Psychology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Liisa A M Galea
- Graduate Program in Neuroscience, University of British Columbia, Vancouver, British Columbia, Canada.,Department of Psychology, University of British Columbia, Vancouver, British Columbia, Canada.,Centre for Brain Health, University of British Columbia, Vancouver, British Columbia, Canada
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Baron S, Ulstein I, Werheid K. Psychosocial interventions in Alzheimer's disease and amnestic mild cognitive impairment: evidence for gender bias in clinical trials. Aging Ment Health 2015; 19:290-305. [PMID: 25048626 DOI: 10.1080/13607863.2014.938601] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND Alzheimer's disease (AD) affects twice as many women as men. Gender differences in symptom profile, living conditions, coping style and response might affect the outcome of psychosocial interventions (PSIs). OBJECTIVES Our aim was to review gender differences in the available high-quality phase III trials on PSI in AD and amnestic mild cognitive impairment (aMCI) by considering the gender ratio in the investigated samples. DESIGN Randomized controlled trials published in 2000-2012 were stepwise analyzed by statistically testing the representativeness of the gender ratio and examining reported gender differences. RESULTS Forty-five studies (62% of 73 studies) reported gender ratios for each subsample and were included. In these studies, females were underrepresented in the control groups. In the 14 studies (19%) reporting analyses of gender differences, women were underrepresented in both intervention and control groups. However, in the six studies (8%) reporting significant gender differences in outcome, gender distribution was in accordance with prevalence rates. CONCLUSION Current evidence is insufficient for reliable conclusions on gender differences in PSI outcome in AD and aMCI, as 81% of the available clinical trials either not reported the gender ratio of their samples, or underrepresent females. Further research is needed addressing gender differences, and clinical trials should routinely control for gender bias.
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Affiliation(s)
- Stefanie Baron
- a Department of Psychology , Humboldt University Berlin , Berlin , Germany
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Rahe J, Liesk J, Rosen JB, Petrelli A, Kaesberg S, Onur OA, Kessler J, Fink GR, Kalbe E. Sex differences in cognitive training effects of patients with amnestic mild cognitive impairment. AGING NEUROPSYCHOLOGY AND COGNITION 2015; 22:620-38. [DOI: 10.1080/13825585.2015.1028883] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Marková H, Laczó J, Andel R, Hort J, Vlček K. Perspective taking abilities in amnestic mild cognitive impairment and Alzheimer's disease. Behav Brain Res 2015; 281:229-38. [DOI: 10.1016/j.bbr.2014.12.033] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2014] [Revised: 12/11/2014] [Accepted: 12/15/2014] [Indexed: 11/15/2022]
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Caselli RJ, Dueck AC, Locke DE, Baxter LC, Woodruff BK, Geda YE. Sex-based memory advantages and cognitive aging: a challenge to the cognitive reserve construct? J Int Neuropsychol Soc 2015; 21:95-104. [PMID: 25665170 PMCID: PMC4785799 DOI: 10.1017/s1355617715000016] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Education and related proxies for cognitive reserve (CR) are confounded by associations with environmental factors that correlate with cerebrovascular disease possibly explaining discrepancies between studies examining their relationships to cognitive aging and dementia. In contrast, sex-related memory differences may be a better proxy. Since they arise developmentally, they are less likely to reflect environmental confounds. Women outperform men on verbal and men generally outperform women on visuospatial memory tasks. Furthermore, memory declines during the preclinical stage of AD, when it is clinically indistinguishable from normal aging. To determine whether CR mitigates age-related memory decline, we examined the effects of gender and APOE genotype on longitudinal memory performances. Memory decline was assessed in a cohort of healthy men and women enriched for APOE ɛ4 who completed two verbal [Rey Auditory Verbal Learning Test (AVLT), Buschke Selective Reminding Test (SRT)] and two visuospatial [Rey-Osterrieth Complex Figure Test (CFT), and Benton Visual Retention Test (VRT)] memory tests, as well as in a separate larger and older cohort [National Alzheimer's Coordinating Center (NACC)] who completed a verbal memory test (Logical Memory). Age-related memory decline was accelerated in APOE ɛ4 carriers on all verbal memory measures (AVLT, p=.03; SRT p<.001; logical memory p<.001) and on the VRT p=.006. Baseline sex associated differences were retained over time, but no sex differences in rate of decline were found for any measure in either cohort. Sex-based memory advantage does not mitigate age-related memory decline in either APOE ɛ4 carriers or non-carriers.
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Affiliation(s)
| | - Amylou C. Dueck
- Department of Biostatistics, Mayo Clinic Arizona, Scottsdale, Arizona
| | - Dona E.C. Locke
- Division of Psychology, Mayo Clinic Arizona, Scottsdale, Arizona
| | - Leslie C. Baxter
- Division of Psychology, Barrow Neurological Institute, Phoenix, Arizona
| | | | - Yonas E. Geda
- Department of Neurology, Mayo Clinic Arizona, Scottsdale, Arizona
- Department of Psychiatry, Mayo Clinic Arizona, Scottsdale, Arizona
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Zhang M, Gale SD, Erickson LD, Brown BL, Woody P, Hedges DW. Cognitive function in older adults according to current socioeconomic status. AGING NEUROPSYCHOLOGY AND COGNITION 2015; 22:534-43. [PMID: 25565407 DOI: 10.1080/13825585.2014.997663] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Cognitive function may be influenced by education, socioeconomic status, sex, and health status. Furthermore, aging interacts with these factors to influence cognition and dementia risk in late life. Factors that may increase or decrease successful cognitive aging are of critical importance, particularly if they are modifiable. The purpose of this study was to determine if economic status in late life is associated with cognition independent of socioeconomic status in early life. Cross-sectional demographic, socioeconomic, and cognitive function data were obtained in 2592 older adults (average age 71.6 years) from the Center for Disease Control's National Health and Nutrition Examination Survey (NHANES) and analyzed with linear regression modeling. Cognitive function, as measured with a test of processing speed, was significantly associated with poverty index scores after adjusting for educational attainment as an estimate of childhood socioeconomic status, ethnic background, age, health status, and sex (P < 0.001). Our findings suggest that current economic status is independently associated with cognitive function in adults over age 60 years.
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Affiliation(s)
- Michael Zhang
- a Department of Psychology , Brigham Young University , Provo , UT , USA
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Speer P, Wersching H, Bruchmann S, Bracht D, Stehling C, Thielsch M, Knecht S, Lohmann H. Age- and gender-adjusted normative data for the German version of Rey's Auditory Verbal Learning Test from healthy subjects aged between 50 and 70 years. J Clin Exp Neuropsychol 2013; 36:32-42. [PMID: 24341534 DOI: 10.1080/13803395.2013.863834] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Rey's Auditory Verbal Learning Test (AVLT) is widely used to evaluate dysfunctional episodic memory. The current study aimed to provide extended age- and gender-specific norms for the German AVLT for individuals older than 50 years. In 690 subjects, a comprehensive medical examination including a structural 3.0-tesla magnetic resonance imaging scan was administered, as well as extensive neuropsychological tests. After controlling for exclusion criteria, 407 subjects were included in the analysis. AVLT performance decreased with age, and women outperformed men. We present age- and gender-specific normative data for the German AVLT from subjects aged between 50 and 70 years.
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Affiliation(s)
- Paula Speer
- a Department of Neurology , University Hospital Münster , Münster , Germany
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Intra-individual reaction time variability in mild cognitive impairment and Alzheimer's disease: gender, processing load and speed factors. PLoS One 2013; 8:e65712. [PMID: 23762413 PMCID: PMC3677873 DOI: 10.1371/journal.pone.0065712] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2012] [Accepted: 04/28/2013] [Indexed: 12/13/2022] Open
Abstract
Compared to cognitively healthy ageing (CH), intra-individual variability in reaction time (IIVRT), a behavioural marker of neurological integrity, is commonly reported to increase in both Alzheimer’s disease (AD) and mild cognitive impairment (MCI). It varies in MCI with respect to whether it represents the pro-dromal stages of dementia or not; being greatest in those most likely to convert. Abnormal IIVRT in MCI therefore represents a potential measure of underlying functional integrity that may serve to differentiate MCI from CH and to help identify those patients for whom MCI is the result of a progressive pathological process. As the clinical approach to MCI is increasingly stratified with respect to gender, we investigated whether this factor could influence study outcome. The influence of RTSPEED and processing load upon IIVRT was also examined. Under low processing load conditions, IIVRT was significantly increased in both MCI and AD compared to CH. However, correcting for an individual’s processing speed abolished this effect in MCI but not in AD, indicating that the increased IIVRT in MCI and AD may result from different factors. In MCI but not in CH, IIVRT was significantly greater for females. Increasing task processing load by adding distracting information, although increasing overall IIVRT, failed to improve the differentiation between CH and both MCI and AD, and in MCI resulted in a reduction in the influence of gender upon study outcome. The outcome of studies investigating IIVRT in MCI and AD compared to CH therefore appear influenced by the gender of the participants, by task-related processing load and processing speed.
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