Abstract P017: Sex Differences Of Longitudinal Changes Of Cognitive Function Over 9 Years Among Older Adults: Findings From Tanushimaru Cohort Study

Abstract

Introduction: Mild cognitive impairment (MCI) is often a precursor to dementia and is therefore of increasing interest. Some previous studies showed MCI progresses to dementia faster in women than in men. However, sex differences in the progression of cognitive decline requires additional study. Hypothesis: Correlates of changing patterns of cognitive function differ between the sexes. Methods: We recruited 2653 participants (mean age: 59.2±12.0 years, male 41.6%) as a population-based sample of Tanushimaru, Japan in 2009 and conducted a longitudinal study with a follow-up examination in 2018. Mini-Mental State Examination (MMSE) was a 30-point test used to assess cognitive function. We classified cognitive function as dementia, MCI and normal using MMSE cutpoints ≤23, 24-27, and ≥28, respectively. We performed analysis of covariance (ANCOVA) to examine the correlates of change in MMSE scores in 973 people who attended in both 2009 and 2018. Results: Mean MMSE scores in 2009 were 27.7±2.5 (men:27.4±2.8, women:27.8±2.3, p=0.0016) and in 2018 were 28.3±2.3 (men:28.3±2.2, women:28.4±2.5). Changes in MMSE scores were 0.47±3.04 in men and 0.26±3.13 in women. Cognition status progressed from normal to MCI or from MCI to dementia over 9 years in 26.3% (men:24.9%, women:27.2%) and 2.6%(men:2.8%, women:2.5%), respectively. On the other hand, 72.0% of MCI (men:69.7%, women:73.4%) reverted to normal cognitive status. Cognitive improvement for 9 years was associated with higher high-density lipoprotein (HDL) cholesterol, lower log-transformed serum insulin in 2009 in men(p=0.0198, p=0.008),and higher estimated glomerular filtration rate (eGFR) in 2009 in women (p=0.058). Lower serum magnesium levels in 2009 were marginally associated with the progression from MCI to dementia in both sexes. (Figure 1). Conclusions: Cognitive status function was better in women and improved in both sexes during 9 years. A sex-stratified approach for describing correlates of cognitive status may be useful.