Journal
JOURNAL OF WOMEN & AGING
Volume 31, Issue 2, Pages 140-164Publisher
ROUTLEDGE JOURNALS, TAYLOR & FRANCIS LTD
DOI: 10.1080/08952841.2018.1419476
Keywords
Alzheimer disease; brain; disease progression; women; hippocampus; magnetic resonance imaging; men; sex characteristics; white matter hyperintensities
Categories
Funding
- NIA/NIH [U01 AG016976]
- NIA [P30 AG019610, P30 AG013846, P50 AG008702, P50 AG025688, P50 AG047266, P30 AG010133, P50 AG005146, P50 AG005134, P50 AG016574, P50 AG005138, P30 AG008051, P30 AG013854, P30 AG008017]
- [P30 AG010161]
- [P50 AG047366]
- [P30 AG010129]
- [P50 AG016573]
- [P50 AG016570]
- [P50 AG005131]
- [P50 AG023501]
- [P30 AG035982]
- [P30 AG028383]
- [P30 AG010124]
- [P50 AG005133]
- [P50 AG005142]
- [P30 AG012300]
- [P50 AG005136]
- [P50 AG033514]
- [P50 AG005681]
- [P50 AG047270]
- NATIONAL INSTITUTE ON AGING [P30AG008051, P50AG047270, P50AG005681, P30AG013854, P30AG010129, P50AG005136, P30AG008017, P50AG005138, P50AG047366, P30AG013846, P50AG023501, P30AG012300, P30AG010161, P30AG028383, P50AG005131, P30AG035982, P50AG005142, P50AG016574, P50AG005133, P50AG016570, P30AG010124, U01AG016976, P50AG005146, P50AG008702, P50AG033514, P50AG005134, P50AG047266, P50AG025688, P50AG016573, P30AG019610, P30AG010133] Funding Source: NIH RePORTER
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This study examined biological sex differences in the development of mild cognitive impairment (MCI) and probable Alzheimer's disease (AD) development as predicted by changes in the hippocampus or white matter hyperintensities. A secondary data analysis of the National Alzheimer's Coordinating Center Uniform Data Set was conducted. We selected samples of participants with normal cognition at baseline who progressed to MCI (n=483) and those who progressed to probable AD (n=211) to determine if hippocampal volume or white matter hyperintensities (WMH) at baseline predicted progression to probable AD or MCI and whether the rate of progression differed between men and women. The survival analyses indicated that changes in hippocampal volumes affected the progression to probable AD (HR=0.535, 95% CI [0.300-0.953]) only among women. White men had an increased rate of progression to AD (HR=4.396, CI [1.012-19.08]; HR=4.665, 95% CI [1.072-20.29]) compared to men in other race and ethnic groups. Among women, increases in hippocampal volume ratio led to decreased rates of progressing to MCI (HR=0.386, 95% CI [0.166-0.901]). Increased WMH among men led to faster progression to MCI (HR=1.048. 95% CI [1.011-1.086]). Women and men who were older at baseline were more likely to progress to MCI. In addition, results from longitudinal analyses showed that women with a higher CDR global score, older age at baseline, or more disinhibition symptoms experienced higher odds of MCI development. Changes in hippocampal volumes affect the progression to or odds of probable AD (and MCI) more so among women than men, while changes in WMH affected the progression to MCI only among men.
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