Abstract
ObjectiveThe potential impact of sex on cognitive performance in normal aging and participants with Alzheimer's disease (AD) has been outlined previously. Nevertheless, differences in neuropsychiatric symptoms (NPS) have been also outlined. We aimed to study a potential association between NPS and cognitive performances according to sex, in older individuals with and without cognitive impairment. MethodsDemographic, neuropsychiatric and neuropsychological data from the ADNI and NACC databases were merged into a dataset of 506 participants with healthy cognitive performance, 467 patients with mild cognitive impairment, and 238 patients with AD. Cognitive performance in each group was evaluated according to sex and the presence of NPS. ResultsBased on sex, cognitive performance differed according to clinical stage: in the healthy controls and AD groups, women had better fluency performance, while in the mild cognitive impairment group, women had better working memory and men better oral naming. Regardless of sex, depression showed a negative effect on processing speed in AD. Finally, there was an interaction between sex and NPS in mild cognitive impairment, where women with apathy had better working memory performance, and in AD, women with depression had better fluency performance. The opposite pattern being was observed in men, where men with depression have worse focused attention. ConclusionCognitive performance is influenced by sex, yet this influence has different manifestations at normal cognition, MCI or AD. Furthermore, apathy and depression seem to influence differently women and men at different types of cognitive decline.
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