Abstract
BackgroundSubjective Cognitive Decline (SCD) is a self-experienced decline in cognitive capacity with normal performance on standardized cognitive tests, showing to increase risk of Alzheimer’s Disease (AD). Cognitive reserve seems to influence the progression from SCD to Mild Cognitive Impairment (MCI) and to AD. The aim of our study was to investigate gender differences in cognitive reserve evaluating how sex might modulate the role of cognitive reserve on SCD.MethodsWe included 381 SCD patients who underwent clinical evaluation, neuropsychological assessment, evaluation of premorbid intelligence by the Test di Intelligenza Breve (TIB), cognitive complaints by the Memory Assessment Clinics Questionnaire (MAC-Q), and apolipoprotein E (APOE) genotyping.ResultsThe proportion between women and men was significantly different (68.7% [95% CI 63.9–73.4 vs 31.4%, 95% CI 26.6–36.0]). Women were younger than men at onset of SCD and at the baseline visit (p = 0.021), had lower years of education (p = 0.007), lower TIB scores (p < 0.001), and higher MAC-Q scores (p = 0.012). TIB was directly associated with age at onset of SCD in both women and men, while years of education was inversely associated with age at onset only in women. Multivariate analysis showed that sex influences TIB independently from years of education. TIB was directly associated with MAC-Q in men.ConclusionsSex interacts with premorbid intelligence and education level in influencing the age at onset and the severity of SCD. As the effect of education was different between men and women, we speculated that education might act as a minor contributor of cognitive reserve in women.
Highlights
Subjective Cognitive Decline (SCD) was defined as a selfexperienced persistent decline of cognitive capacity in comparison with the subject’s previously normal status, during which the subject has normal age, sex, and educationadjusted performance on standardized cognitive tests [1]
We aimed to investigate gender differences in cognitive reserve evaluating how sex might modulate the role of cognitive reserve on SCD
Our study aimed to investigate gender differences in cognitive reserve evaluating how sex might modulate the role of cognitive reserve on SCD
Summary
Subjective Cognitive Decline (SCD) was defined as a selfexperienced persistent decline of cognitive capacity in comparison with the subject’s previously normal status, during which the subject has normal age-, sex-, and educationadjusted performance on standardized cognitive tests [1]. Several studies applying multifactorial approaches found that demographic and genetic factors, such as age at onset [1, 8], APOE ε4 genotype [8], and cognitive reserve [9,10,11], may influence the risk of progression from SCD to MCI and dementia. Subjective Cognitive Decline (SCD) is a self-experienced decline in cognitive capacity with normal performance on standardized cognitive tests, showing to increase risk of Alzheimer’s Disease (AD). Women were younger than men at onset of SCD and at the baseline visit (p = 0.021), had lower years of education (p = 0.007), lower TIB scores (p < 0.001), and higher MAC-Q scores (p = 0.012). Conclusions Sex interacts with premorbid intelligence and education level in influencing the age at onset and the severity of SCD. As the effect of education was different between men and women, we speculated that education might act as a minor contributor of cognitive reserve in women
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