Sex differences in risk factors, burden, and outcomes of cerebrovascular disease in Alzheimer's disease populations

BACKGROUND White matter hyperintensities (WMHs) are associated with cognitive decline and progression to mild cognitive impairment (MCI) and dementia. It remains unclear if sex differences influence WMH progression or the relationship between WMH and cognition. METHODS Linear mixed models examined t...

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Published inAlzheimer's & dementia Vol. 20; no. 1; pp. 34 - 46
Main Authors Morrison, Cassandra, Dadar, Mahsa, Collins, Donald Louis
Format Journal Article
LanguageEnglish
Published United States John Wiley & Sons, Inc 01.01.2024
John Wiley and Sons Inc
Subjects
Alzheimer's disease
Cerebrovascular disease
cognition
Cognition & reasoning
Cognitive impairment
Dementia
Executive function
Females
Gender differences
Hypertension
Males
older adults
Pathology
Resilience
Risk factors
Risk reduction
Sex differences
white matter hyperintensities
older adults
cognition
white matter hyperintensities
sex differences
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Summary:BACKGROUND White matter hyperintensities (WMHs) are associated with cognitive decline and progression to mild cognitive impairment (MCI) and dementia. It remains unclear if sex differences influence WMH progression or the relationship between WMH and cognition. METHODS Linear mixed models examined the relationship between risk factors, WMHs, and cognition in males and females. RESULTS Males exhibited increased WMH progression in occipital, but lower progression in frontal, total, and deep than females. For males, history of hypertension was the strongest contributor, while in females, the vascular composite was the strongest contributor to WMH burden. WMH burden was more strongly associated with decreases in global cognition, executive functioning, memory, and functional activities in females than males. DISCUSSION Controlling vascular risk factors may reduce WMH in both males and females. For males, targeting hypertension may be most important to reduce WMHs. The results have implications for therapies/interventions targeting cerebrovascular pathology and subsequent cognitive decline. Highlights Hypertension is the main vascular risk factor associated with WMH in males A combination of vascular risk factors contributes to WMH burden in females Only small WMH burden differences were observed between sexes Females’ cognition was more negatively impacted by WMH burden than males Females with WMHs may have less resilience to future pathology
Bibliography:Data used in preparation of this article were obtained from the Alzheimer's Disease Neuroimaging Initiative (ADNI) database (adni.loni.usc.edu). As such, the investigators within the ADNI contributed to the design and implementation of ADNI and/or provided data but did not participate in analysis or writing of this report. A complete listing of ADNI investigators can be found at
http://adni.loni.usc.edu/wp‐content/uploads/how_to_apply/ADNI_Acknowledgement_List.pdf
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Data used in preparation of this article were obtained from the Alzheimer's Disease Neuroimaging Initiative (ADNI) database (adni.loni.usc.edu). As such, the investigators within the ADNI contributed to the design and implementation of ADNI and/or provided data but did not participate in analysis or writing of this report. A complete listing of ADNI investigators can be found at: http://adni.loni.usc.edu/wp‐content/uploads/how_to_apply/ADNI_Acknowledgement_List.pdf
ISSN:1552-5260
1552-5279
1552-5279
DOI:10.1002/alz.13452