Mild Cognitive Impairment In Women Research Articles

Development and Impact of a Cognitive Reserve Enhancement Program for Climacteric Korean Women

ABSTRACT Background In light of the rising incidence of mild cognitive impairment in women, an appropriate cognitive reserve enhancement program is urgently needed for women experiencing climacteric symptoms. Purpose The purpose of this study was to develop a cognitive reserve enhancement program for climacteric women based on cognitive reserve theory (CRT) and to verify its effectiveness. Methods A nonequivalence control group, pre- and post-quasi-experimental design was used. The 58 climacteric women with subjective memory deterioration enrolled as participants were divided into the experimental group (28 women), which received a 24-session CRT-based cognitive reserve enhance program, and the control group (30 women), the members of which received the cognitive training via a mobile application after completion of the study. Valid data from 24 experimental and 26 control participants were available for analysis. Objective cognitive functions, including overall cognitive, memory, attention, and language, were measured pretest and posttest using the following tools: Everyday Cognition Scale (subjective cognitive function), Center for Epidemiologic Studies Depression Scale (depression), and World Health Organization Quality of Life-Brief Version (quality of life). Results The experimental group showed a statistically significant increase in overall cognitive function (t = 3.82, p = .001), memory (t = 2.63, p = .012), attention: number of correct answers (t = 2.12, p = .040), language high-frequency response speed (Z = −2.49, p = .013), and language low-frequency response speed (Z = −2.77, p = .006) in objective cognitive function after 8 weeks in comparison to the control group. Conclusions/Implications for Practice The intervention program tested in this study to enhance cognitive reserve in climacteric women includes cognitive training, emotional and social support, and group physical activity components was found to be effective in enhancing cognitive function.

The neutrophil-to-lymphocyte ratio is associated with mild cognitive impairment in community-dwelling older women aged over 70 years: a population-based cross-sectional study.

The neutrophil-to-lymphocyte ratio (NLR) is a marker of inflammation that can be obtained quickly, conveniently, and cheaply from blood samples. However, there is no research to explore the effects of sex and age on the relationship between the NLR and mild cognitive impairment (MCI) in community-dwelling older adults. A total of 3,126 individuals aged over 60 years in Shanghai were recruited for face-to-face interviews, and blood samples were collected. MCI was assessed by the Mini-Mental State Examination (MMSE) and the Instrumental Activities of Daily Living (IADL) scale, and neutrophil count and lymphocyte counts were measured in fasting blood samples. The NLR was calculated by dividing the absolute neutrophil count by the absolute lymphocyte count. In females, the NLR in the MCI group was significantly higher than that in the cognitively normal group (2.13 ± 0.94 vs. 1.85 ± 0.83, p < 0.001) but not in men. Logistic regression showed that a higher NLR was an independent risk factor for MCI in women [odds ratio (OR) = 1.33; 95% confidence interval (CI) = 1.14-1.55]. In addition, the elevated NLR quartile was associated with an increased risk of MCI, especially in women older than 70 years (p value for trend = 0.012). Compared with males, female MCI patients had a significantly higher NLR than cognitively normal controls. In addition, elevated NLR was found to be significantly associated with MCI risk in women older than 70 years. Therefore, elderly Chinese women with a higher NLR value may be the target population for effective prevention of MCI.

Is the association between cognitive disease progression and atrial fibrillation modified by sex?

It is unclear if sex differences exist in cognitive disease progression in mild cognitive impairment (MCI) and dementia associated with atrial fibrillation (AF). Using a variety of statistical methods, we examined sex differences between AF and neuropsychological tests and cognitive disease progression, using the National Alzheimer's Coordinating Center data (N=43,630). AF is associated with higher odds of dementia (odds ratio [OR] 3.00, 95% confidence interval [CI] [1.22, 7.37] in women and MCI in women (OR 3.43, 95% CI [1.55, 7.55]) versus men. Women with AF and normal baseline cognition had a higher risk of disease progression (hazard ratio [HR] 1.26, 95% CI [1.06, 1.50]) from normal to MCI and from MCI to vascular dementia (HR3.27, 95% CI [1.89, 5.65]) than men with AF or men and women without AF. AF was associated with more rapid progression to MCI and dementia in women, but more research is needed to confirm these findings.

Association of tamoxifen and raloxifene therapy with cognitive performance, odds of mild cognitive impairment, and neuroimaging markers of neurodegeneration

AbstractBackgroundTamoxifen is used as a selective estrogen receptor modifier (SERM) to treat hormone receptor‐positive breast cancer. Raloxifene, another SERM, has been used for the treatment of osteoporosis in post‐menopausal women. The aim of this cross‐sectional study was to examine whether a history of tamoxifen or raloxifene use was associated with cognitive performance, odds of mild cognitive impairment (MCI), or structural neurodegenerative MRI markers.MethodThe study included women with and without a personal history of breast cancer enrolled in the Mayo Clinic Study of Aging (MCSA). A history of breast cancer and use of SERMs before the MCSA enrollment visit was abstracted using the Rochester Epidemiology Project medical‐linkage system. Participants had a diagnosis of MCI (prevalent) at the time of enrollment into the MCSA. Logistic regression was used to examine associations of SERMs with odds of MCI. Linear regression models were used to examine associations of SERMs with cognitive measures z‐scores (Memory, Executive Function, Language, Visuospatial Skills, Global Cognition), hippocampal volume, and Alzheimer’s disease signature cortical thickness.ResultAmong the women aged ≥ 50 at enrollment in the MCSA, 151 had a history of breast cancer, and 2235 had no prior history of any cancer. Of the 151 women with a history of breast cancer, 42 (28%) had taken tamoxifen and 109 (72%) had not at enrollment in the MCSA; 54 had neuroimaging data (tamoxifen = 16; no tamoxifen = 38). Among the women without prior history of cancer at enrollment in the MCSA, 76 (3%) had taken raloxifene and 2159 (97%) had not; 755 had neuroimaging data (raloxifene = 25; no raloxifene = 730). No significant associations between tamoxifen with global or domain‐specific cognition or odds of MCI were observed among women with a history of breast cancer after adjusting for confounders (Table 1). Likewise raloxifene was not significantly associated with global or domain‐specific cognition or odds of MCI in women without a history of cancer after adjusting for confounders (Table 2). We did not find significant associations between SERMs and any neuroimaging outcome (Table 3).ConclusionOur results suggest use of tamoxifen or raloxifene is not significantly associated with cognition in postmenopausal women.

Association between Lifespan Exercise Habits and Cognitive Function in Older Age: the Bunkyo Health Study

AbstractBackgroundPreventing or delaying the onset of mild cognitive impairment (MCI) is a crucial strategy for maintaining an independent life in old age (Rodakowski J et al., 2014). Exercise habits for ∼ ten years in the 50s or older were associated with preserving cognitive function (Rovio, S., et al., 2005; J Krell‐Roesch, et al., 2021). However, it is still unclear whether continuous exercise habits throughout the 50s to late life are required to prevent MCI. This study aimed to investigate the association between continuity of exercise habits from the 50s to late life and MCI in older age.MethodWe included 1585 participants (669 males and 916 females) aged 65 to 84 years old living in an urban area (Bunkyo Health Study). MCI was defined as the Japanese version of The Montreal Cognitive Assessment score of 22 points or less. Participants were divided into three groups based on continuity of exercise habits in each decade of the 50s to current age: never having exercise habits in their 50s to current [Never group, reference], having exercise habits in one or several of ages from 50s to current [Intermittent group], and having continuous exercise habits in all of ages [Continuous group]. The odds ratio (ORs) for the prevalence of MCI were obtained using logistic regression models while adjusting for potential confounders including age, years of education, body fat percentage, smoking history, alcohol intake, and cognition‐related diseases (hypertension, diabetes mellitus, dyslipidemia, cerebrovascular disease).ResultCompared with the Never group, none of the ORs for MCI were statistically significant in men (Intermittent group: ORs: 0.60, 95%CI: 0.36 – 1.02; Continuous group: ORs: 0.99, 95%CI: 0.61 – 1.63; P for trend: P = 0.93). In contrast, the ORs for MCI were significantly lower in the Continuous group in women (Intermittent group: ORs: 0.74, 95%CI: 0.47 – 1.17; Continuous group: ORs: 0.50, 95%CI: 0.29‐0.87; P for trend: P = 0.01).ConclusionMore sustained exercise participation from the 50s to late life was associated with a lower prevalence of MCI in women but not in men.

Gender-specific prevalence and risk factors of mild cognitive impairment among older adults in Chongming, Shanghai, China.

ObjectiveThis study explores the gender differences in the prevalence of mild cognitive impairment (MCI) and the correlation between multiple influencing factors.Materials and methodsThe sample was comprised of 1325 relatively healthy participants aged ≥ 60 years in a Shanghai community-dwelling (557 males and 768 females). Cognitive function was assessed by Mini-Mental State Examination (MMSE). The Instrumental Activities of Daily Living (IADL) scale was used to assess the activities of daily living.ResultsThe overall prevalence of MCI was 15.2%, with 10.2% in men and 18.9% in women. In older male subjects, those with higher the Geriatric Depression Scale (GDS) scores [odds ratio (OR) = 1.07, 95% confidence interval (CI) = 1.01–1.14] and hypertension (OR = 2.33, 95% CI = 1.15–4.73) had a higher risk of MCI. female subjects who were illiterate (OR = 2.95, 95% CI = 1.82–4.78), had a farming background (OR = 1.69, 95% CI = 1.05–2.72), and a history of stroke (OR = 1.96, 95% CI = 1.07–3.59) had a higher risk of MCI, but this was not true for males. However, Male subjects who never smoked were less likely to have MCI (OR = 0.22, 95% CI = 0.09–0.54). Additionally, the prevalence of MCI was lower in older women with high grip strength (OR = 0.96, 95% CI = 0.92–0.99) and hyperlipidemia (OR = 0.45, 95% CI = 0.22–0.96).ConclusionThe prevalence of MCI was higher in the population of elderly women compared to men. Moreover, it was found that members with MCI tended to having higher GDS scores, smoking, and hypertension; whereas a history of farming, illiteracy, stroke, grip strength, and hyperlipidemia were correlated with MCI in women.

Association of raloxifene and tamoxifen therapy with cognitive performance, odds of mild cognitive impairment, and brain MRI markers of neurodegeneration.

The aim of this cross-sectional study was to examine whether a history of selective estrogen receptor modifiers (SERMs), tamoxifen and raloxifene, use was associated with cognitive performance, odds of mild cognitive impairment (MCI), or magnetic resonance imaging (MRI) markers of neurodegeneration associated with Alzheimer's disease. We included women with prior history of breast cancer or no prior history of any cancer at enrollment in the Mayo Clinic Study of Aging (MCSA). This information was abstracted using the Rochester Epidemiology Project medical-linkage system. Logistic regression was used to examine associations of SERMs with odds of MCI. Linear regression models were used to examine associations of SERMs with cognitive z-scores (Memory, Executive Function, Language, Visuospatial Skills, Global Cognition), and MRI markers. Among 2840 women aged 50 and older in the MCSA, 151 had a history of breast cancer, and 42 (28%) of these had a history of tamoxifen treatment. A total of 2235 women had no prior history of any cancer, and 76 (3%) of these had a history of raloxifene use. No significant associations between tamoxifen use and cognition, or odds of MCI were observed among women with a history of breast cancer after adjusting for confounders. Similarly, raloxifene use was not significantly associated with cognition, or odds of MCI in women without a history of cancer after adjusting for confounders. We did not find significant associations between the use of either SERM and MRI markers. Use of tamoxifen or raloxifene was not significantly associated with cognition in postmenopausal women.

Decomposition of gender differences in cognitive functioning: National Survey of the Japanese elderly

BackgroundIt is well known that females generally live longer than males, but women tend to suffer from more illnesses and limitations than men do, also for dementia. However, limited empirical evidence is available why this ‘male-female health-survival paradox’ is observed. This study aimed to investigate factors which account for gender differences in health, particularly cognitive functioning and decline among older adults.MethodsData were retrieved from the National Survey of the Japanese Elderly, which is a longitudinal survey of a nationwide representative sample of Japanese adults aged 60 or over. Gender differences in cognitive functioning and decline in three-year follow-ups were decomposed using Blinder–Oaxaca decomposition analysis, regarding demographic, socioeconomic, and health-related factors into the ‘explained’ component, by differences in individual attributes listed above, and the ‘unexplained’ component.ResultsEmpirical analyses showed that women’s lower cognitive functioning was partly explained by the endowment effect. Moreover, a shorter duration of formal education and a larger proportion with their longest occupation being domestic worker accounted for steeper cognitive decline and more prevalent mild cognitive impairment in women than in men.ConclusionThis empirical study suggested that gender differences in cognitive functioning and decline account for different individual attributes of social determinants among men and women. Particularly, men seem to be more engaged in activities which accumulate intellectual experiences through education and occupation, as suggested by the cognitive reserve hypothesis.

Sex- and age-specific mild cognitive impairment is associated with low hand grip strength in an older Chinese cohort.

BackgroundFew studies have demonstrated the impact of characteristics like age and sex on the association between hand grip strength (HGS) and mild cognitive impairment (MCI). In this cross-sectional study, we aimed to examine the effects of sex and age on the relationship between HGS and MCI.MethodsWe enrolled older adults age ≥60 years (n = 1009) and measured HGS and MCI in all participants. We analyzed the differences in MCI prevalence among the different variables. The role of sex and age in the association between MCI and HGS was analyzed using binary logistic regression.ResultsWomen had significantly higher prevalence of MCI than men, as did the older group (age ≥70 years) compared with the younger group (age 60–70 years). In men, the low and middle HGS tertiles were significantly associated with MCI. In contrast, only the low tertile of HGS was associated with MCI in women. In the older group, the low tertile of HGS was significantly associated with MCI, which was not observed in the younger group.ConclusionsHGS was associated with MCI in older adults, and this association was stronger in men. HGS may be useful for evaluating MCI in older adults.

Cognitive function and predictors for mild cognitive impairment in women receiving adjuvant hormone therapy.

e11082 Background: Women with breast cancer (BC) often complained memory loss and attention deficit after cancer treatment. However, cognitive function deficit was multivariate issues. The purpose ...

Conjugated Equine Estrogens and Incidence of Probable Dementia and Mild Cognitive Impairment in Postmenopausal Women: Women???s Health Initiative Memory Study

Previous findings from the Women’s Health Initiative Memory Study (WHIMS) have suggested an increased risk of dementia, but not mild cognitive impairment (MCI), in women given conjugated equine estrogens (CEE) plus medroxyprogesterone acetate (MPA). The present report presents data from the WHIMS, a randomized, double-blind, placebo-controlled trial, when assessing the effects of CEE alone and CEE plus MPA on the risk of dementia and MIC in community-living women 65 to 79 years of age. The participants, including 4532 women given estrogen plus progestin and 2947 given estrogen only, entered the trial in the years 1995–2002. Women received a daily tablet of 0.625 mg CEE or matching placebo, or else a combination of 0.625 mg CEE and 2.5 mg MPA daily with matching placebos. The women were screened annually using the Modified Mini-Mental State Examination and, if indicated, underwent a battery of neuropsychologic tests and standardized interviews. The risk of probable dementia during follow up was 49% greater in women assigned to CEE compared with placebo recipients (37 vs. 25 per 10,000 person-years). Comparable rates of probable dementia were recorded for women in the CEE alone and CEE plus MPA group, and the hazard ratios (HRs) did not differ significantly. The risk of MCI was 34% higher in women taking CEE alone than in their matched placebo recipients (HR, 1.34). There was no significant increase in risk in the combined medication trial. The hazard ratio for either probable dementia or MCI in women given CEE alone, compared with placebo women, was 1.38. These findings from the WHIMS indicate that older women who take CEE alone or CEE plus MPA are at increased risk of dementia or MCI. The investigators recommend that women aged 65 and older not be given hormone therapy with the goal of preventing dementia or MCI.

Estrogen replacement therapy, Alzheimer's disease, and mild cognitive impairment.

This article highlights the latest findings regarding estrogen replacement therapy in the treatment and prevention of Alzheimer's disease (AD) and mild cognitive impairment in women. Despite considerable evidence from observational studies, recent randomized clinical trials of conjugated equine estrogens, alone and in combination with progestin, have shown no benefit for either the treatment of established AD or for the short-term prevention of AD, mild cognitive impairment, or cognitive decline. Based on the evidence, there is no role at present for estrogen replacement therapy in the treatment or prevention of AD or cognitive decline, despite intriguing results from the laboratory and from observational studies. However, numerous questions remain about the biologic effects of estrogens on brain structure and function. Additional basic and clinical investigations are necessary to examine different forms and dosages of estrogens, other populations, and the relevance of timing and duration of exposure.