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Lui KK, Dave A, Sprecher KE, Chappel-Farley MG, Riedner BA, Heston MB, Taylor CE, Carlsson CM, Okonkwo OC, Asthana S, Johnson SC, Bendlin BB, Mander BA, Benca RM. Older adults at greater risk for Alzheimer's disease show stronger associations between sleep apnea severity in REM sleep and verbal memory. Alzheimers Res Ther 2024; 16:102. [PMID: 38725033 PMCID: PMC11080222 DOI: 10.1186/s13195-024-01446-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 04/01/2024] [Indexed: 05/12/2024]
Abstract
BACKGROUND Obstructive sleep apnea (OSA) increases risk for cognitive decline and Alzheimer's disease (AD). While the underlying mechanisms remain unclear, hypoxemia during OSA has been implicated in cognitive impairment. OSA during rapid eye movement (REM) sleep is usually more severe than in non-rapid eye movement (NREM) sleep, but the relative effect of oxyhemoglobin desaturation during REM versus NREM sleep on memory is not completely characterized. Here, we examined the impact of OSA, as well as the moderating effects of AD risk factors, on verbal memory in a sample of middle-aged and older adults with heightened AD risk. METHODS Eighty-one adults (mean age:61.7 ± 6.0 years, 62% females, 32% apolipoprotein E ε4 allele (APOE4) carriers, and 70% with parental history of AD) underwent clinical polysomnography including assessment of OSA. OSA features were derived in total, NREM, and REM sleep. REM-NREM ratios of OSA features were also calculated. Verbal memory was assessed with the Rey Auditory Verbal Learning Test (RAVLT). Multiple regression models evaluated the relationships between OSA features and RAVLT scores while adjusting for sex, age, time between assessments, education years, body mass index (BMI), and APOE4 status or parental history of AD. The significant main effects of OSA features on RAVLT performance and the moderating effects of AD risk factors (i.e., sex, age, APOE4 status, and parental history of AD) were examined. RESULTS Apnea-hypopnea index (AHI), respiratory disturbance index (RDI), and oxyhemoglobin desaturation index (ODI) during REM sleep were negatively associated with RAVLT total learning and long-delay recall. Further, greater REM-NREM ratios of AHI, RDI, and ODI (i.e., more events in REM than NREM) were related to worse total learning and recall. We found specifically that the negative association between REM ODI and total learning was driven by adults 60 + years old. In addition, the negative relationships between REM-NREM ODI ratio and total learning, and REM-NREM RDI ratio and long-delay recall were driven by APOE4 carriers. CONCLUSION Greater OSA severity, particularly during REM sleep, negatively affects verbal memory, especially for people with greater AD risk. These findings underscore the potential importance of proactive screening and treatment of REM OSA even if overall AHI appears low.
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Affiliation(s)
- Kitty K Lui
- San Diego State University/University of California San Diego, Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA
- Department of Psychiatry and Human Behavior, University of California, Irvine, CA, USA
| | - Abhishek Dave
- Department of Psychiatry and Human Behavior, University of California, Irvine, CA, USA
- Department of Cognitive Sciences, University of California, Irvine, CA, USA
| | - Kate E Sprecher
- Department of Population Health Sciences, University of Wisconsin-Madison, Madison, WI, USA
- Neuroscience Training Program, University of Wisconsin-Madison, Madison, WI, USA
- Department of Medicine, University of Wisconsin-Madison, Madison, WI, USA
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin-Madison, Madison, WI, USA
| | - Miranda G Chappel-Farley
- Department of Neurobiology and Behavior, University of California, Irvine, CA, USA
- Center for the Neurobiology of Learning and Memory, University of California, Irvine, CA, USA
| | - Brady A Riedner
- Department of Psychiatry, University of Wisconsin-Madison, Madison, WI, USA
| | - Margo B Heston
- Department of Medicine, University of Wisconsin-Madison, Madison, WI, USA
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin-Madison, Madison, WI, USA
| | - Chase E Taylor
- Department of Neuroscience, University of Kentucky, Lexington, KY, USA
| | - Cynthia M Carlsson
- Department of Medicine, University of Wisconsin-Madison, Madison, WI, USA
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin-Madison, Madison, WI, USA
- Wisconsin Alzheimer's Institute, Madison, WI, USA
- Geriatric Research Education and Clinical Center, Wm. S. Middleton Veterans Hospital, Madison, WI, USA
| | - Ozioma C Okonkwo
- Department of Medicine, University of Wisconsin-Madison, Madison, WI, USA
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin-Madison, Madison, WI, USA
- Wisconsin Alzheimer's Institute, Madison, WI, USA
- Geriatric Research Education and Clinical Center, Wm. S. Middleton Veterans Hospital, Madison, WI, USA
| | - Sanjay Asthana
- Department of Medicine, University of Wisconsin-Madison, Madison, WI, USA
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin-Madison, Madison, WI, USA
- Wisconsin Alzheimer's Institute, Madison, WI, USA
- Geriatric Research Education and Clinical Center, Wm. S. Middleton Veterans Hospital, Madison, WI, USA
| | - Sterling C Johnson
- Department of Medicine, University of Wisconsin-Madison, Madison, WI, USA
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin-Madison, Madison, WI, USA
- Wisconsin Alzheimer's Institute, Madison, WI, USA
- Geriatric Research Education and Clinical Center, Wm. S. Middleton Veterans Hospital, Madison, WI, USA
| | - Barbara B Bendlin
- Department of Medicine, University of Wisconsin-Madison, Madison, WI, USA
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin-Madison, Madison, WI, USA
- Wisconsin Alzheimer's Institute, Madison, WI, USA
- Geriatric Research Education and Clinical Center, Wm. S. Middleton Veterans Hospital, Madison, WI, USA
| | - Bryce A Mander
- Department of Psychiatry and Human Behavior, University of California, Irvine, CA, USA.
- Department of Cognitive Sciences, University of California, Irvine, CA, USA.
- Center for the Neurobiology of Learning and Memory, University of California, Irvine, CA, USA.
| | - Ruth M Benca
- Department of Psychiatry and Human Behavior, University of California, Irvine, CA, USA.
- Neuroscience Training Program, University of Wisconsin-Madison, Madison, WI, USA.
- Center for the Neurobiology of Learning and Memory, University of California, Irvine, CA, USA.
- Department of Psychiatry, University of Wisconsin-Madison, Madison, WI, USA.
- Department of Psychiatry and Behavioral Medicine, Wake Forest University, Winston-Salem, NC, USA.
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Williamson JN, James SA, Mullen SP, Sutton BP, Wszalek T, Mulyana B, Mukli P, Yabluchanskiy A, Yang Y. Sex differences in interacting genetic and functional connectivity biomarkers in Alzheimer's disease. GeroScience 2024:10.1007/s11357-024-01151-x. [PMID: 38598069 DOI: 10.1007/s11357-024-01151-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Accepted: 04/01/2024] [Indexed: 04/11/2024] Open
Abstract
As of 2023, it is estimated that 6.7 million individuals in the United States live with Alzheimer's disease (AD). Prior research indicates that AD disproportionality affects females; females have a greater incidence rate, perform worse on a variety of neuropsychological tasks, and have greater total brain atrophy. Recent research shows that hippocampal functional connectivity differs by sex and may be related to the observed sex differences in AD, and apolipoprotein E (ApoE) ε4 carriers have reduced hippocampal functional connectivity. The purpose of this study was to determine if the ApoE genotype plays a role in the observed sex differences in hippocampal functional connectivity in Alzheimer's disease. The resting state fMRI and T2 MRI of individuals with AD (n = 30, female = 15) and cognitively normal individuals (n = 30, female = 15) from the Alzheimer's Disease Neuroimaging Initiative (ADNI) were analyzed using the functional connectivity toolbox (CONN). Our results demonstrated intrahippocampal functional connectivity differed between those without an ε4 allele and those with at least one ε4 allele in each group. Additionally, intrahippocampal functional connectivity differed only by sex when Alzheimer's participants had at least one ε4 allele. These results improve our current understanding of the role of the interacting relationship between sex, ApoE genotype, and hippocampal function in AD. Understanding these biomarkers may aid in the development of sex-specific interventions for improved AD treatment.
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Affiliation(s)
- Jordan N Williamson
- Grainger College of Engineering, Department of Bioengineering, University of Illinois Urbana-Champaign, Urbana, IL, USA
| | - Shirley A James
- Hudson College of Public Health, University of Oklahoma Health Science Center, Oklahoma City, OK, USA
| | - Sean P Mullen
- Beckman Institute for Advanced Science and Technology, University of Illinois Urbana-Champaign, Urbana, IL, USA
- Department of Kinesiology & Community Health, University of Illinois Urbana-Champaign, Urbana, IL, USA
- Informatics Programs, University of Illinois Urbana-Champaign, Urbana, IL, USA
- Center for Social & Behavioral Sciences, University of Illinois Urbana-Champaign, Urbana, IL, USA
| | - Bradley P Sutton
- Grainger College of Engineering, Department of Bioengineering, University of Illinois Urbana-Champaign, Urbana, IL, USA
- Beckman Institute for Advanced Science and Technology, University of Illinois Urbana-Champaign, Urbana, IL, USA
| | - Tracey Wszalek
- Beckman Institute for Advanced Science and Technology, University of Illinois Urbana-Champaign, Urbana, IL, USA
| | - Beni Mulyana
- Grainger College of Engineering, Department of Bioengineering, University of Illinois Urbana-Champaign, Urbana, IL, USA
| | - Peter Mukli
- Vascular Cognitive Impairment and Neurodegeneration Program, Oklahoma Center for Geroscience and Healthy Brain Aging, Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Andriy Yabluchanskiy
- Vascular Cognitive Impairment and Neurodegeneration Program, Oklahoma Center for Geroscience and Healthy Brain Aging, Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Yuan Yang
- Grainger College of Engineering, Department of Bioengineering, University of Illinois Urbana-Champaign, Urbana, IL, USA.
- Beckman Institute for Advanced Science and Technology, University of Illinois Urbana-Champaign, Urbana, IL, USA.
- Clinical Imaging Research Center, Stephenson Family Clinical Research Institute, Carle Foundation Hospital, Urbana, IL, USA.
- Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, IL, USA.
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Williamson J, James SA, Mukli P, Yabluchanskiy A, Wu DH, Sonntag W, Yang Y. Sex difference in brain functional connectivity of hippocampus in Alzheimer's disease. GeroScience 2024; 46:563-572. [PMID: 37743414 PMCID: PMC10828268 DOI: 10.1007/s11357-023-00943-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 09/11/2023] [Indexed: 09/26/2023] Open
Abstract
Alzheimer's disease (AD), affecting nearly 6.5 million people, is the fifth leading cause of death in individuals 65 years or older in the USA. Prior research has shown that AD disproportionality affects females; females have a greater incidence rate, perform worse on a variety of neuropsychological tasks, and have greater total brain atrophy. Recent research has linked these sex differences to neuroimaging markers of brain pathology, such as hippocampal volumes. Specifically, research from our lab found that functional connectivity from the hippocampus to the precuneus cortex and brain stem was significantly stronger in males than in females with mild cognitive impairment. The aim of this study was to extend our understanding to individuals with AD and to determine if these potential sex-specific functional connectivity biomarkers extend through different disease stages. The resting state fMRI and T2 MRI of cognitively normal individuals (n = 32, female = 16) and individuals with AD (n = 32, female = 16) from the Alzheimer's Disease Neuroimaging Initiative (ADNI) were analyzed using the Functional Connectivity Toolbox (CONN). Our results demonstrate that males had a significantly stronger interhemispheric functional connectivity between the left and right hippocampus compared to females. These results improve our current understanding of the role of the hippocampus in sex differences in AD. Understanding the contribution of impaired functional connectivity sex differences may aid in the development of sex-specific precision medicine for improved AD treatment.
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Affiliation(s)
- Jordan Williamson
- Department of Bioengineering, University of Illinois Urbana-Champaign, Urbana, IL, USA
| | - Shirley A James
- Department of Public Health, Health Science Center, University of Oklahoma, Oklahoma City, OK, USA
| | - Peter Mukli
- Vascular Cognitive Impairment and Neurodegeneration Program, Oklahoma Center for Geroscience and Healthy Brain Aging, Department of Neurosurgery, Health Sciences Center, University of Oklahoma, Oklahoma City, OK, USA
| | - Andriy Yabluchanskiy
- Vascular Cognitive Impairment and Neurodegeneration Program, Oklahoma Center for Geroscience and Healthy Brain Aging, Department of Neurosurgery, Health Sciences Center, University of Oklahoma, Oklahoma City, OK, USA
| | - Dee H Wu
- Department of Radiological Science and Medical Physics, Health Science Center, University of Oklahoma, Oklahoma City, OK, USA
- Data Institute for Societal Challenges, University of Oklahoma, Norman, OK, USA
- Beckman Institute for Advanced Science and Technology, University of Illinois Urbana-Champaign, Urbana, IL, USA
| | - William Sonntag
- Vascular Cognitive Impairment and Neurodegeneration Program, Oklahoma Center for Geroscience and Healthy Brain Aging, Department of Neurosurgery, Health Sciences Center, University of Oklahoma, Oklahoma City, OK, USA
| | - Yuan Yang
- Department of Bioengineering, University of Illinois Urbana-Champaign, Urbana, IL, USA.
- Department of Rehabilitation Sciences, Health Science Center, University of Oklahoma, Oklahoma City, OK, USA.
- Data Institute for Societal Challenges, University of Oklahoma, Norman, OK, USA.
- Beckman Institute for Advanced Science and Technology, University of Illinois Urbana-Champaign, Urbana, IL, USA.
- SFCRI Clinical Imaging Research Center, Carle Foundation Hospital, Urbana, IL, USA.
- Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, IL, USA.
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Lui K, Dave A, Sprecher K, Chappel-Farley M, Riedner B, Heston M, Taylor C, Carlsson C, Okonkwo O, Asthana S, Johnson S, Bendlin B, Mander B, Benca R. Older adults at greater risk for Alzheimer's disease show stronger associations between sleep apnea severity and verbal memory. RESEARCH SQUARE 2023:rs.3.rs-3683218. [PMID: 38076899 PMCID: PMC10705699 DOI: 10.21203/rs.3.rs-3683218/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/22/2023]
Abstract
Background Obstructive sleep apnea (OSA) increases risk for cognitive decline and Alzheimer's disease (AD). While the underlying mechanisms remain unclear, hypoxemia during OSA has been implicated in cognitive impairment. OSA during rapid eye movement (REM) sleep is usually more severe than in non-rapid eye movement (NREM) sleep, but the relative effect of oxyhemoglobin desaturation during REM versus NREM sleep on memory is not completely characterized. Here, we examined the impact of OSA, as well as the moderating effects of AD risk factors, on verbal memory in a sample of middle-aged and older adults with heightened AD risk. Methods Eighty-one adults (mean age:61.7±6.0 years, 62% females, 32% apolipoprotein E ε4 allele (APOE4) carriers, and 70% with parental history of AD) underwent clinical polysomnography including assessment of OSA. OSA features were derived in total, NREM, and REM sleep. REM-NREM ratios of OSA features were also calculated. Verbal memory was assessed with the Rey Auditory Verbal Learning Test (RAVLT). Multiple regression models evaluated the relationships between OSA features and RAVLT scores while adjusting for sex, age, time between assessments, education years, body mass index (BMI), and APOE4 status or parental history of AD. The significant main effects of OSA features on RAVLT performance and the moderating effects of AD risk factors (i.e., sex, age, APOE4 status, and parental history of AD) were examined. Results Apnea-hypopnea index (AHI), respiratory disturbance index (RDI), and oxyhemoglobin desaturation index (ODI) during REM sleep were negatively associated with RAVLT total learning and long-delay recall. Further, greater REM-NREM ratios of AHI, RDI, and ODI (i.e., more events in REM than NREM) were related to worse total learning and recall. We found specifically that the negative association between REM ODI and total learning was driven by adults 60+ years old. In addition, the negative relationships between REM-NREM ODI ratio and total learning and REM-NREM RDI ratio and long-delay recall were driven by APOE4 carriers. Conclusion Greater OSA severity, particularly during REM sleep, negatively affects verbal memory, especially for people with greater AD risk. These findings underscore the potential importance of proactive screening and treatment of REM OSA even if overall AHI appears low.
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Affiliation(s)
- Kitty Lui
- San Diego State University/University of California San Diego, Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA
| | - Abhishek Dave
- Department of Cognitive Sciences, University of California, Irvine
| | - Kate Sprecher
- Department of Population Health Sciences, University of Wisconsin-Madison
| | | | - Brady Riedner
- Department of Psychiatry, University of Wisconsin-Madison
| | - Margo Heston
- Department of Medicine, University of Wisconsin-Madison
| | - Chase Taylor
- Department of Neuroscience, University of Kentucky
| | - Cynthia Carlsson
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin-Madison
| | - Ozioma Okonkwo
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin-Madison
| | - Sanjay Asthana
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin-Madison
| | - Sterling Johnson
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin-Madison
| | | | - Bryce Mander
- Department of Psychiatry and Human Behavior, University of California, Irvine
| | - Ruth Benca
- Department of Psychiatry and Behavioral Medicine, Wake Forest University
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Santiago JA, Potashkin JA. Biological and Clinical Implications of Sex-Specific Differences in Alzheimer's Disease. Handb Exp Pharmacol 2023; 282:181-197. [PMID: 37460661 DOI: 10.1007/164_2023_672] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/13/2023]
Abstract
Mounting evidence indicates that the female sex is a risk factor for Alzheimer's disease (AD), the most common cause of dementia worldwide. Decades of research suggest that sex-specific differences in genetics, environmental factors, hormones, comorbidities, and brain structure and function may contribute to AD development. However, although significant progress has been made in uncovering specific genetic factors and biological pathways, the precise mechanisms underlying sex-biased differences are not fully characterized. Here, we review several lines of evidence, including epidemiological, clinical, and molecular studies addressing sex differences in AD. In addition, we discuss the challenges and future directions in advancing personalized treatments for AD.
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Affiliation(s)
| | - Judith A Potashkin
- Cellular and Molecular Pharmacology Department, Center for Neurodegenerative Diseases and Therapeutics, The Chicago Medical School, Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA.
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Chang YL, Moscovitch M. Sex differences in item and associative memory among older adults with amnestic mild cognitive impairment. Neuropsychologia 2022; 176:108375. [PMID: 36179862 DOI: 10.1016/j.neuropsychologia.2022.108375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 09/01/2022] [Accepted: 09/22/2022] [Indexed: 10/31/2022]
Abstract
In older adults without cognitive impairment, women have an advantage over men in verbal memory tests; however, whether women with amnestic mild cognitive impairment (aMCI) exhibit this advantage remains controversial. We evaluated sex-specific differences in older adults with and without aMCI in item and associative verbal memory by using an associative memory task with immediate and delayed recognition conditions. The associations between memory task performances and medial temporal morphometric measures were examined. The study included 49 individuals with aMCI and 55 healthy older adults (HOs). The results revealed that a female advantage in immediate item and delayed associative memory was evident in HOs, and the female advantage in associative memory persisted even after item memory performance was controlled. By contrast, the female advantage was absent in individuals with aMCI; such women had more associative false alarms than men with aMCI. Furthermore, decreases in item memory, associative memory, and cortical thickness in the perirhinal and entorhinal regions in individuals with aMCI versus their sex-matched controls were more prominent in women than in men. The relation between brain structure and associative memory function was evident only for women, indicating that women and men may have different cognitive and neural mechanisms for processing associative memory. These findings support the concept of cognitive reserve in women during normal aging. Accounting for sex differences in verbal memory performance is crucial to improve aMCI identification, particularly for women.
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Affiliation(s)
- Yu-Ling Chang
- Department of Psychology, College of Science, National Taiwan University, Taipei, 10617, Taiwan; Neurobiology and Cognitive Science Center, National Taiwan University, Taipei, 10617, Taiwan; Department of Neurology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, 10048, Taiwan; Center for Artificial Intelligence and Advanced Robotics, National Taiwan University, Taipei, 10617, Taiwan.
| | - Morris Moscovitch
- Rotman Research Institute, Baycrest Health Sciences, Toronto, ON M6A 2E1, Canada; Department of Psychology, University of Toronto, Toronto, ON M5S 3G3, Canada
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Williamson J, Yabluchanskiy A, Mukli P, Wu DH, Sonntag W, Ciro C, Yang Y. Sex differences in brain functional connectivity of hippocampus in mild cognitive impairment. Front Aging Neurosci 2022; 14:959394. [PMID: 36034134 PMCID: PMC9399646 DOI: 10.3389/fnagi.2022.959394] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 07/19/2022] [Indexed: 11/13/2022] Open
Abstract
Mild cognitive impairment (MCI) is the prodromal stage of Alzheimer's Disease (AD). Prior research shows that females are more impacted by MCI than males. On average females have a greater incidence rate of any dementia and current evidence suggests that they suffer greater cognitive deterioration than males in the same disease stage. Recent research has linked these sex differences to neuroimaging markers of brain pathology, such as hippocampal volumes. Specifically, the rate of hippocampal atrophy affects the progression of AD in females more than males. This study was designed to extend our understanding of the sex-related differences in the brain of participants with MCI. Specifically, we investigated the difference in the hippocampal connectivity to different areas of the brain. The Resting State fMRI and T2 MRI of cognitively normal individuals (n = 40, female = 20) and individuals with MCI (n = 40, female = 20) from the Alzheimer's Disease Neuroimaging Initiative (ADNI) were analyzed using the Functional Connectivity Toolbox (CONN). Our results demonstrate that connectivity of hippocampus to the precuneus cortex and brain stem was significantly stronger in males than in females. These results improve our current understanding of the role of hippocampus-precuneus cortex and hippocampus-brainstem connectivity in sex differences in MCI. Understanding the contribution of impaired functional connectivity sex differences may aid in the development of sex specific precision medicine to manipulate hippocampal-precuneus cortex and hippocampal-brainstem connectivity to decrease the progression of MCI to AD.
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Affiliation(s)
- Jordan Williamson
- Neural Control and Rehabilitation Laboratory, Stephenson School of Biomedical Engineering, University of Oklahoma, Norman, OK, United States
| | - Andriy Yabluchanskiy
- Vascular Cognitive Impairment and Neurodegeneration Program, Oklahoma Center for Geroscience and Healthy Brain Aging, Department of Biochemistry and Molecular Biology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Peter Mukli
- Vascular Cognitive Impairment and Neurodegeneration Program, Oklahoma Center for Geroscience and Healthy Brain Aging, Department of Biochemistry and Molecular Biology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Dee H. Wu
- Department of Radiological Science and Medical Physics, University of Oklahoma Health Science Center, Oklahoma City, OK, United States
- Data Institute for Societal Challenges, University of Oklahoma, Norman, OK, United States
- School of Computer Science, Gallogly College of Engineering, University of Oklahoma, Norman, OK, United States
- School of Electrical and Computer Engineering, Gallogly College of Engineering, University of Oklahoma, Norman, OK, United States
| | - William Sonntag
- Vascular Cognitive Impairment and Neurodegeneration Program, Oklahoma Center for Geroscience and Healthy Brain Aging, Department of Biochemistry and Molecular Biology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Carrie Ciro
- Department of Rehabilitation Sciences, University of Oklahoma Health Science Center, Oklahoma City, OK, United States
| | - Yuan Yang
- Neural Control and Rehabilitation Laboratory, Stephenson School of Biomedical Engineering, University of Oklahoma, Norman, OK, United States
- Data Institute for Societal Challenges, University of Oklahoma, Norman, OK, United States
- Department of Rehabilitation Sciences, University of Oklahoma Health Science Center, Oklahoma City, OK, United States
- School of Electrical and Computer Engineering, University of Oklahoma, Tulsa, OK, United States
- Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, IL, United States
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Corriveau-Lecavalier N, Décarie-Labbé L, Mellah S, Belleville S, Rajah MN. Sex differences in patterns of associative memory-related activation in individuals at risk of Alzheimer's disease. Neurobiol Aging 2022; 119:89-101. [PMID: 35985098 DOI: 10.1016/j.neurobiolaging.2022.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 07/05/2022] [Accepted: 07/20/2022] [Indexed: 11/15/2022]
Abstract
The risk of developing Alzheimer's disease dementia is higher in females compared to males and is greater in individuals with subjective cognitive decline and mild cognitive impairment than in healthy controls. We used a multivariate behavioral partial least square correlation analysis to examine how relationships between memory-related activation and associative memory performance vary as a function of sex and clinical status. This was assessed in 182 participants from the Consortium for the Early Identification of Alzheimer's Disease-Quebec cohort, which were stratified according to sex (Male, Female) and clinical status (healthy controls, subjective cognitive decline, mild cognitive impairment). We found 6 significant latent variables mainly expressing: (1) overall sex differences; (2) between-sex differences according to clinical status; and (3) within-sex differences according to clinical status in relationships between whole-brain memory-related activation and memory performance. These patterns of activation mostly involved the default mode and fronto-parietal networks. Our results have implication in understanding the macro-scale functional processes possibly contributing to the higher risk of cognitive decline in females compared to males in the context of aging and early Alzheimer's disease.
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Affiliation(s)
| | - Laurie Décarie-Labbé
- Research Centre, Institut universitaire de geriatrie de Montreal, Montreal, Quebec, Canada; Department of Psychology, Universite de Montreal, Montreal, Quebec, Canada
| | - Samira Mellah
- Research Centre, Institut universitaire de geriatrie de Montreal, Montreal, Quebec, Canada
| | - Sylvie Belleville
- Research Centre, Institut universitaire de geriatrie de Montreal, Montreal, Quebec, Canada; Department of Psychology, Universite de Montreal, Montreal, Quebec, Canada
| | - Maria Natasha Rajah
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada; Douglas Research Centre, Montreal, Quebec, Canada.
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Abstract
Sex and gender differences are seen in cognitive disturbances in a variety of neurological and psychiatry diseases. Men are more likely to have cognitive symptoms in schizophrenia whereas women are more likely to have more severe cognitive symptoms with major depressive disorder and Alzheimer's disease. Thus, it is important to understand sex and gender differences in underlying cognitive abilities with and without disease. Sex differences are noted in performance across various cognitive domains - with males typically outperforming females in spatial tasks and females typically outperforming males in verbal tasks. Furthermore, there are striking sex differences in brain networks that are activated during cognitive tasks and in learning strategies. Although rarely studied, there are also sex differences in the trajectory of cognitive aging. It is important to pay attention to these sex differences as they inform researchers of potential differences in resilience to age-related cognitive decline and underlying mechanisms for both healthy and pathological cognitive aging, depending on sex. We review literature on the progressive neurodegenerative disorder, Alzheimer's disease, as an example of pathological cognitive aging in which human females show greater lifetime risk, neuropathology, and cognitive impairment, compared to human males. Not surprisingly, the relationships between sex and cognition, cognitive aging, and Alzheimer's disease are nuanced and multifaceted. As such, this chapter will end with a discussion of lifestyle factors, like education and diet, as modifiable factors that can alter cognitive aging by sex. Understanding how cognition changes across age and contributing factors, like sex differences, will be essential to improving care for older adults.
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Chapman RM, Gardner MN, Lyons M. Gender Differences in Emotional Connotative Meaning of Words Measured by Osgood's Semantic Differential Techniques in Young Adults. HUMANITIES & SOCIAL SCIENCES COMMUNICATIONS 2022; 9:119. [PMID: 36118842 PMCID: PMC9479698 DOI: 10.1057/s41599-022-01126-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 03/10/2022] [Indexed: 06/15/2023]
Abstract
Semantic differential techniques are a useful, well-validated tool to assess affective processing of stimuli and determine how that processing is impacted by various demographic factors, such as gender. In this paper, we explore differences in connotative word processing between men and women as measured by Osgood's semantic differential and what those differences imply about affective processing in the two genders. We recruited 94 young participants (47 men, 47 women, ages 18-39) using an online survey and collected their affective ratings of 120 words on three rating tasks: Evaluation (E), Potency (P), and Activity (A). With these data, we explored the theoretical and mathematical overlap between Osgood's affective meaning factor structure and other models of emotional processing commonly used in gender analyses. We then used Osgood's three-dimensional structure to assess gender-related differences in three affective classes of words (words with connotation that is Positive, Neutral, or Negative for each task) and found that there was no significant difference between the genders when rating Positive words and Neutral words on each of the three rating tasks. However, young women consistently rated Negative words more negatively than young men did on all three of the independent dimensions. This confirms the importance of taking gender effects into account when measuring emotional processing. Our results further indicate there may be differences between Osgood's structure and other models of affective processing that should be further explored.
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Affiliation(s)
- Robert M. Chapman
- Department of Brain and Cognitive Sciences and Center for Visual Science at the University of Rochester, Rochester, New York, United States of America
| | - Margaret N. Gardner
- Department of Brain and Cognitive Sciences and Center for Visual Science at the University of Rochester, Rochester, New York, United States of America
| | - Megan Lyons
- Department of Brain and Cognitive Sciences and Center for Visual Science at the University of Rochester, Rochester, New York, United States of America
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11
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Oltra J, Uribe C, Campabadal A, Inguanzo A, Monté-Rubio GC, Martí MJ, Compta Y, Valldeoriola F, Junque C, Segura B. Sex Differences in Brain and Cognition in de novo Parkinson's Disease. Front Aging Neurosci 2022; 13:791532. [PMID: 35069180 PMCID: PMC8770804 DOI: 10.3389/fnagi.2021.791532] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 12/13/2021] [Indexed: 12/31/2022] Open
Abstract
Background and Objective: Brain atrophy and cognitive impairment in neurodegenerative diseases are influenced by sex. We aimed to investigate sex differences in brain atrophy and cognition in de novo Parkinson's disease (PD) patients. Methods: Clinical, neuropsychological and T1-weighted MRI data from 205 PD patients (127 males: 78 females) and 69 healthy controls (40 males: 29 females) were obtained from the PPMI dataset. Results: PD males had a greater motor and rapid eye movement sleep behavior disorder symptomatology than PD females. They also showed cortical thinning in postcentral and precentral regions, greater global cortical and subcortical atrophy and smaller volumes in thalamus, caudate, putamen, pallidum, hippocampus, and brainstem, compared with PD females. Healthy controls only showed reduced hippocampal volume in males compared to females. PD males performed worse than PD females in global cognition, immediate verbal recall, and mental processing speed. In both groups males performed worse than females in semantic verbal fluency and delayed verbal recall; as well as females performed worse than males in visuospatial function. Conclusions: Sex effect in brain and cognition is already evident in de novo PD not explained by age per se, being a relevant factor to consider in clinical and translational research in PD.
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Affiliation(s)
- Javier Oltra
- Medical Psychology Unit, Department of Medicine, Institute of Neurosciences, University of Barcelona, Barcelona, Spain
- Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Carme Uribe
- Medical Psychology Unit, Department of Medicine, Institute of Neurosciences, University of Barcelona, Barcelona, Spain
- Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Research Imaging Centre, Centre for Addiction and Mental Health, Campbell Family Mental Health Research Institute, University of Toronto, Toronto, ON, Canada
| | - Anna Campabadal
- Medical Psychology Unit, Department of Medicine, Institute of Neurosciences, University of Barcelona, Barcelona, Spain
- Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Anna Inguanzo
- Medical Psychology Unit, Department of Medicine, Institute of Neurosciences, University of Barcelona, Barcelona, Spain
- Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Gemma C. Monté-Rubio
- Medical Psychology Unit, Department of Medicine, Institute of Neurosciences, University of Barcelona, Barcelona, Spain
| | - Maria J. Martí
- Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas, Hospital Clínic de Barcelona, Barcelona, Spain
- Parkinson's Disease and Movement Disorders Unit, Neurology Service, Hospital Clínic de Barcelona, Institute of Neurosciences, University of Barcelona, Barcelona, Spain
| | - Yaroslau Compta
- Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas, Hospital Clínic de Barcelona, Barcelona, Spain
- Parkinson's Disease and Movement Disorders Unit, Neurology Service, Hospital Clínic de Barcelona, Institute of Neurosciences, University of Barcelona, Barcelona, Spain
| | - Francesc Valldeoriola
- Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas, Hospital Clínic de Barcelona, Barcelona, Spain
- Parkinson's Disease and Movement Disorders Unit, Neurology Service, Hospital Clínic de Barcelona, Institute of Neurosciences, University of Barcelona, Barcelona, Spain
| | - Carme Junque
- Medical Psychology Unit, Department of Medicine, Institute of Neurosciences, University of Barcelona, Barcelona, Spain
- Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Barbara Segura
- Medical Psychology Unit, Department of Medicine, Institute of Neurosciences, University of Barcelona, Barcelona, Spain
- Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas, Hospital Clínic de Barcelona, Barcelona, Spain
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12
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Stefanidou M, O’Donnell A, Himali JJ, DeCarli C, Satizabal C, Beiser AS, Seshadri S, Zaldy T. Bone Mineral Density Measurements and Association With Brain Structure and Cognitive Function: The Framingham Offspring Cohort. Alzheimer Dis Assoc Disord 2021; 35:291-297. [PMID: 33973881 PMCID: PMC8608007 DOI: 10.1097/wad.0000000000000453] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 03/24/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Bone mineral density (BMD) is a potential surrogate marker of lifetime estrogen exposure previously linked to increased risk of Alzheimer dementia among elderly women. We examine the association between BMD in the "young old" with imaging biomarkers of brain aging and cognitive performance. METHODS Offspring participants (N=1905, mean age 66) of a population-based cohort who had BMD, brain imaging and detailed cognitive assessment were included in the study. Sex-stratified, linear, and logistic regression models were used for analysis. RESULTS Higher femoral neck BMD was associated with lower white matter hyperintensity burden and better performance on Trails B-A in both sexes, even after adjustment for cerebrovascular risk factors. Among women, the positive association with Trails B-A performance was seen only in APOE4 allele carriers. Higher BMD measurements were linked to better visual reproductions test performance in men. Finally, among women, higher femoral trochanter BMD was associated with better logical memory and Hooper visual organization test performance. CONCLUSION Among the "young old," higher BMD is associated with less white matter hyperintensity burden and better, domain-specific, cognitive performance. This suggests that lifetime estrogen exposure may modulate the degree of cumulative vascular brain injury independent of cerebrovascular risk factors.
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Affiliation(s)
- Maria Stefanidou
- The Framingham Heart Study, Framingham
- Department of Neurology, Boston University School of Medicine
| | - Adrienne O’Donnell
- The Framingham Heart Study, Framingham
- Department of Biostatistics, Boston University School of Public Health, Boston, MA
| | - Jayandra J. Himali
- The Framingham Heart Study, Framingham
- Department of Neurology, Boston University School of Medicine
- Department of Biostatistics, Boston University School of Public Health, Boston, MA
- Glenn Biggs Institute for Alzheimer’s and Neurodegenerative Diseases
- Department of Population Health Sciences, University of Texas Health Science Center, San Antonio, TX
| | | | - Claudia Satizabal
- The Framingham Heart Study, Framingham
- Glenn Biggs Institute for Alzheimer’s and Neurodegenerative Diseases
| | - Alexa S. Beiser
- The Framingham Heart Study, Framingham
- Department of Neurology, Boston University School of Medicine
- Department of Biostatistics, Boston University School of Public Health, Boston, MA
| | - Sudha Seshadri
- The Framingham Heart Study, Framingham
- Department of Neurology, Boston University School of Medicine
- Glenn Biggs Institute for Alzheimer’s and Neurodegenerative Diseases
| | - Tan Zaldy
- Division of Geriatrics, David Geffen School of Medicine at the University of California, Los Angeles, CA
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13
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Gong X, Liang Z, Liu W, Zhao Y, Yang Y, Wu M, Shang J, Xiao Y, Mei Y, Su Q, Sun B, Bao J, Shu X. High fat diet aggravates AD-related pathogenic processes in APP/PS1 mice. Curr Alzheimer Res 2021; 18:310-325. [PMID: 34212829 DOI: 10.2174/1567205018666210628100812] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Revised: 04/10/2021] [Accepted: 05/04/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Alzheimer's disease (AD) is the most common neurodegenerative disorder and negative life-style factors may contribute to its etiopathogenesis. Substantial evidence from humans and murine models reveal that Insulin Resistance (IR) associated with high fat diet (HFD) increase the risk of developing AD and age-related amyloidogenesis. OBJECTIVE To corroborate and clarify the influence of HFD on amyloidogenesis and cognitive deficits in AD model mice. RESULTS We here show that a four months HFD-feeding increases IR in both the periphery and brain of APP/PS1 mice, which are used as AD model. Meanwhile, long term HFD exacerbates cognitive defects and impairs dendritic integrity and expressions of synaptic proteins in APP/PS1 mice. Furthermore, HFD induces an increase in β-secretase (BACE1) expression and a decrease in insulin degrading enzyme (IDE) expression, resulting in β-amyloid (Aβ) accumulation. CONCLUSION Our data suggests that long term HFD, with the accompanying IR, promotes Aβ toxicity and cognitive deficits, indicating that modifiable life-style hazards such as HFD-induced IR might contribute to AD pathogenesis.
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Affiliation(s)
- Xiaokang Gong
- Institutes of Biomedical Sciences, School of Medicine, Jianghan University, China
| | - Zheng Liang
- Institutes of Biomedical Sciences, School of Medicine, Jianghan University, China
| | - Wei Liu
- Institutes of Biomedical Sciences, School of Medicine, Jianghan University, China
| | - Yang Zhao
- Institute of bioengineering and food, Hubei University of Technology, Wuhan, China
| | - Youhua Yang
- Department of Pathology and Pathophysiology, School of Medicine, Jianghan University, Wuhan, China
| | - Mengjuan Wu
- Institutes of Biomedical Sciences, School of Medicine, Jianghan University, China
| | - Jinting Shang
- Institutes of Biomedical Sciences, School of Medicine, Jianghan University, China
| | - Yifan Xiao
- Institutes of Biomedical Sciences, School of Medicine, Jianghan University, China
| | - Yong Mei
- Institutes of Biomedical Sciences, School of Medicine, Jianghan University, China
| | - Qiqi Su
- Institutes of Biomedical Sciences, School of Medicine, Jianghan University, China
| | - Binlian Sun
- Institutes of Biomedical Sciences, School of Medicine, Jianghan University, China
| | - Jian Bao
- Institutes of Biomedical Sciences, School of Medicine, Jianghan University, China
| | - Xiji Shu
- Institutes of Biomedical Sciences, School of Medicine, Jianghan University, China
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14
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Zaheed AB, Sharifian N, Morris EP, Kraal AZ, Zahodne LB. Associations between life course marital biography and late-life memory decline. Psychol Aging 2021; 36:557-571. [PMID: 34166026 DOI: 10.1037/pag0000617] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Late-life marital status is associated with cognitive aging; however, the influence of life course marital biography (i.e., changes in marital status) on late-life cognitive trajectories, as well as gender differences in the effects of marital biography, remain to be explored. Associations between (a) marital status at study baseline (currently married, previously married, never married) and (b) retrospectively reported life course marital biography (i.e., age at first marriage, time spent unmarried following initial marriage, history of divorce, history of widowhood) and up to 20 years of subsequent episodic memory trajectories were examined using latent growth curve models in 3,061 participants aged 51 + in the Health and Retirement Study 2017 Life History Mail Survey. Gender differences were examined with multiplicative interaction terms and stratified models. Participants who were married at study baseline demonstrated higher initial memory than previously and never married individuals. Older age at first marriage and shorter duration spent unmarried were each associated with better initial episodic memory among previously married individuals only; longer duration spent unmarried was associated with slower memory decline. Stratified models suggested that these associations may be driven by women. These results highlight the importance of considering multiple aspects of marital biography, not just current marital status, in cognitive aging research. Marital biography may have an enduring influence on cognitive aging, particularly among previously married older women. Future work is needed to identify mechanisms (e.g., socioeconomic resources, cognitive stimulation, self and spousal health, emotional support) through which marital histories influence cognitive aging. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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15
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Cuervo-Zanatta D, Garcia-Mena J, Perez-Cruz C. Gut Microbiota Alterations and Cognitive Impairment Are Sexually Dissociated in a Transgenic Mice Model of Alzheimer's Disease. J Alzheimers Dis 2021; 82:S195-S214. [PMID: 33492296 DOI: 10.3233/jad-201367] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Normal aging is accompanied by cognitive deficiencies, affecting women and men equally. Aging is the main risk factor for Alzheimer's disease (AD), with women having a higher risk. The higher prevalence of AD in women is associated with the abrupt hormonal decline seen after menopause. However, other factors may be involved in this sex-related cognitive decline. Alterations in gut microbiota (GM) and its bioproducts have been reported in AD subjects and transgenic (Tg) mice, having a direct impact on brain amyloid-β pathology in male (M), but not in female (F) mice. OBJECTIVE The aim of this work was to determine GM composition and cognitive dysfunction in M and F wildtype (WT) and Tg mice, in a sex/genotype segregation design. METHODS Anxiety, short term working-memory, spatial learning, and long-term spatial memory were evaluated in 6-month-old WT and Tg male mice. Fecal short chain fatty acids were determined by chromatography, and DNA sequencing and bioinformatic analyses were used to determine GM differences. RESULTS We observed sex-dependent differences in cognitive skills in WT mice, favoring F mice. However, the cognitive advantage of females was lost in Tg mice. GM composition showed few sex-related differences in WT mice. Contrary, Tg-M mice presented a more severe dysbiosis than Tg-F mice. A decreased abundance of Ruminococcaceae was associated with cognitive deficits in Tg-F mice, while butyrate levels were positively associated with better working- and object recognition-memory in WT-F mice. CONCLUSION This report describes a sex-dependent association between GM alterations and cognitive impairment in a mice model of AD.
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Affiliation(s)
- Daniel Cuervo-Zanatta
- Pharmacology Department, Center for Research and Advanced Studies of the National Polytechnic Institute (Cinvestav), Laboratory of Neuroplasticity and Neurodegeneration, Mexico City, Mexico.,Genetics and Molecular Biology Department, Center for Research and Advanced Studies of the National Polytechnic Institute (Cinvestav), Laboratory of reference and support for the characterization of genomes, transcriptomes and microbiomes, Mexico City, Mexico
| | - Jaime Garcia-Mena
- Genetics and Molecular Biology Department, Center for Research and Advanced Studies of the National Polytechnic Institute (Cinvestav), Laboratory of reference and support for the characterization of genomes, transcriptomes and microbiomes, Mexico City, Mexico
| | - Claudia Perez-Cruz
- Pharmacology Department, Center for Research and Advanced Studies of the National Polytechnic Institute (Cinvestav), Laboratory of Neuroplasticity and Neurodegeneration, Mexico City, Mexico
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16
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Mogle J, Hill NL, Turner JR. Individual Differences and Features of Self-reported Memory Lapses as Risk Factors for Alzheimer Disease Among Adults Aged 50 Years and Older: Protocol for a Coordinated Analysis Across Two Longitudinal Data Sets. JMIR Res Protoc 2021; 10:e25233. [PMID: 33988514 PMCID: PMC8164128 DOI: 10.2196/25233] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 03/29/2021] [Accepted: 04/13/2021] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Increasing evidence has promoted the clinical utility of self-reported memory problems for detecting early impairment associated with Alzheimer disease (AD). However, previous studies investigating memory problems often conflated the types of problems (ie, retrospective and prospective) with their features (ie, frequency and consequences). This bias limits the specificity of traditional measures of memory problems and minimizes their ability to detect differential trajectories associated with cognitive decline. In this study, we use a novel measure of self-reported memory problems that uses daily reports of memory lapses to disentangle types from features for analyzing the impact of each dimension in two longitudinal data sets. Furthermore, this study explores the individual difference factors of age and gender as potential moderators of the relationships between self-reported memory lapses and objective cognitive decline. OBJECTIVE The aim of this study is to describe the protocol for a secondary data analysis project that explores the relationship between experiences of daily memory lapses and their associations with cognitive decline in middle-aged and older adults. METHODS This study uses multilevel, coordinated analyses across two measurement burst data sets to examine the links between features and consequences of memory lapses (retrospective and prospective) and their association with objective cognitive decline. This study's sample (N=392; aged 50-85 years; n=254, 64.8% women) is drawn from two ongoing, nationally funded research studies: The Effects of Stress on Cognitive Aging, Physiology, and Emotion study and the Einstein Aging Study. Both studies assess the daily experience of memory lapses, including the type as well as the emotional and functional outcomes, and objective measures of cognition, such as processing speed and episodic memory. We will use multilevel modeling to test our conceptual model demonstrating that differences in frequency and types of memory lapses show differential trends in their relationships with cognitive decline and that these relationships vary by the age and gender of participants. RESULTS This project was funded in August 2019. The approval for secondary data analysis was given by the institutional review board in February 2020. Data analysis for this project has not yet started. CONCLUSIONS The early and accurate identification of individuals most at risk for cognitive decline is of paramount importance. Previous research exploring self-reported memory problems and AD is promising; however, limitations in measurement may explain previous reports of inconsistences. This study addresses these concerns by examining daily reports of memory lapses, how these vary by age and gender, and their relationship with objective cognitive performance. Overall, this study aims to identify the key features of daily memory lapses and the differential trajectories that best predict cognitive decline to help inform future AD risk screening tools. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/25233.
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Affiliation(s)
- Jacqueline Mogle
- Edna Bennett Pierce Prevention Research Center, College of Health and Human Development, Pennsylvania State University, University Park, PA, United States
| | - Nikki L Hill
- College of Nursing, Pennsylvania State University, University Park, PA, United States
| | - Jennifer R Turner
- Edna Bennett Pierce Prevention Research Center, College of Health and Human Development, Pennsylvania State University, University Park, PA, United States
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Rabipour S, Rajagopal S, Pasvanis S, Rajah MN. Generalization of memory-related brain function in asymptomatic older women with a family history of late onset Alzheimer's Disease: Results from the PREVENT-AD Cohort. Neurobiol Aging 2021; 104:42-56. [PMID: 33964608 DOI: 10.1016/j.neurobiolaging.2021.03.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 03/04/2021] [Accepted: 03/18/2021] [Indexed: 11/18/2022]
Abstract
Late-onset Alzheimer's disease (AD) disproportionately affects women compared to men. Episodic memory decline is one of the earliest and most pronounced deficits observed in AD. However, it remains unclear whether sex influences episodic memory-related brain function in cognitively intact older adults at risk of developing AD. Here we used task-based multivariate partial least squares analysis to examine sex differences in episodic memory-related brain activity and brain activity-behavior correlations in a matched sample of cognitively intact older women and men with a family history of AD from the PREVENT-AD cohort study in Montreal, Canada (Mage=63.03±3.78; Meducation=15.41±3.40). We observed sex differences in task-related brain activity and brain activity-behavior correlations during the encoding of object-location associative memories and object-only item memory, and the retrieval of object only item memories. Our findings suggest a generalization of episodic memory-related brain activation and performance in women compared to men. Follow up analyses should test for sex differences in the relationship between brain activity patterns and performance longitudinally, in association with risk factors for AD development. This article is part of the Virtual Special Issue titled COGNITIVE NEUROSCIENCE OF HEALTHY AND PATHOLOGICAL AGING. The full issue can be found on ScienceDirect at https://www.sciencedirect.com/journal/neurobiology-of-aging/special-issue/105379XPWJP.
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Affiliation(s)
- Sheida Rabipour
- Centre for Cerebral Imaging, Douglas Hospital Research Centre, Montreal, Canada; Department of Psychiatry, McGill University, Montreal, Canada
| | | | - Stamatoula Pasvanis
- Centre for Cerebral Imaging, Douglas Hospital Research Centre, Montreal, Canada
| | - M Natasha Rajah
- Centre for Cerebral Imaging, Douglas Hospital Research Centre, Montreal, Canada; Department of Psychiatry, McGill University, Montreal, Canada.
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18
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Zhou Y, Xu B, Yu H, Zhao W, Song X, Liu Y, Wang K, Peacher N, Zhao X, Zhang HT. Biochanin A Attenuates Ovariectomy-Induced Cognition Deficit via Antioxidant Effects in Female Rats. Front Pharmacol 2021; 12:603316. [PMID: 33815102 PMCID: PMC8010695 DOI: 10.3389/fphar.2021.603316] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 01/19/2021] [Indexed: 01/05/2023] Open
Abstract
Background: Impairment of memory and cognition is one of the major symptoms in women with postmenopausal disorders due to estrogen deficiency, which accounts for the much higher prevalence of Alzheimer’s disease in females. Biochanin A (BCA), a natural phytoestrogen, has been reported to protect neurons against ischemic brain injury. However, the neuroprotective effects of BCA in the postmenopausal-like model of ovariectomized (OVX) rats remain to be investigated. Methods: All the rats except for the sham group underwent the resection of bilateral ovaries. Seven days after the OVX surgery, rats were randomly divided into six groups: sham, OVX, OVX + BCA (5 mg/kg), OVX + BCA (20 mg/kg), OVX + BCA (60 mg/kg), and OVX + estradiol (E2; 0.35 mg/kg), which were administrated daily by gavage for 12 weeks. Learning and memory were examined using the Morris water-maze test before the end of the experiment. Morphological changes of the rat hippocampus were observed by HE staining and electron microscopy. Malondialdehyde (MDA), superoxide dismutase (SOD), and glutathione peroxidase (GSH-Px) in the hippocampus were measured. The effect of BCA on cell viability was measured in the presence of hydrogen peroxide (H2O2) using CCK8. Flow cytometry was used to measure neuronal apoptosis and reactive oxygen species (ROS) induced by H2O2. Expression of Bcl-2, Bax, and Caspase-3 was determined by Western blotting using hippocampal tissues and primary cultures of hippocampal neurons. Results: Chronic treatment with BCA mimicked the ability of E2 to reverse the deficit of learning and memory in the Morris water-maze test in OVX rats. BCA normalized OVX-induced morphological changes as revealed by HE staining and electron microscopy. In addition, BCA significantly decreased the levels of MDA, the biomarker of oxidative damage, and increased the activity of the intracellular antioxidant enzymes SOD and GSH-Px in OVX rats. Further, in primary cultures of hippocampal neurons, BCA reversed H2O2-induced decreases in cell viability and accumulation of ROS. Finally, BCA reversed OVX- or H2O2-induced increases in Bax and Caspase-3 and decreases in Bcl-2 in the hippocampus and primary cultures of hippocampal neurons. Conclusion: These results suggest that BCA improves memory through its neuroprotective properties in the brain under the circumstance of estrogen deficiency and can be used for treatment of memory loss in postmenopausal women.
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Affiliation(s)
- Yanmeng Zhou
- Institute of Pharmacology, Shandong First Medical University and Shandong Academy of Medical Sciences, Taian, China
| | - Bingbing Xu
- Institute of Pharmacology, Shandong First Medical University and Shandong Academy of Medical Sciences, Taian, China
| | - Haiyang Yu
- Institute of Pharmacology, Shandong First Medical University and Shandong Academy of Medical Sciences, Taian, China
| | - Wei Zhao
- Institute of Pharmacology, Shandong First Medical University and Shandong Academy of Medical Sciences, Taian, China
| | - Xinxin Song
- Institute of Pharmacology, Shandong First Medical University and Shandong Academy of Medical Sciences, Taian, China
| | - Yan Liu
- The Second Affiliated Hospital of Shandong First Medical University, Taian, China
| | - Kainan Wang
- Institute of Pharmacology, Shandong First Medical University and Shandong Academy of Medical Sciences, Taian, China
| | - Nikoli Peacher
- Departments of Neuroscience and Behavioral Medicine and Psychiatry, Rockefeller Neurosciences Institute, West Virginia University Health Sciences Center, Morgantown, WV, United States
| | - Xiaomin Zhao
- Institute of Pharmacology, Shandong First Medical University and Shandong Academy of Medical Sciences, Taian, China
| | - Han-Ting Zhang
- Departments of Neuroscience and Behavioral Medicine and Psychiatry, Rockefeller Neurosciences Institute, West Virginia University Health Sciences Center, Morgantown, WV, United States
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Cremona S, Jobard G, Zago L, Mellet E. Word Meaning Contributes to Free Recall Performance in Supraspan Verbal List-Learning Tests. Front Psychol 2020; 11:2043. [PMID: 32922343 PMCID: PMC7457129 DOI: 10.3389/fpsyg.2020.02043] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 07/23/2020] [Indexed: 11/13/2022] Open
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20
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Ardekani BA, Izadi NO, Hadid SA, Meftah AM, Bachman AH. Effects of sex, age, and apolipoprotein E genotype on hippocampal parenchymal fraction in cognitively normal older adults. Psychiatry Res Neuroimaging 2020; 301:111107. [PMID: 32416384 DOI: 10.1016/j.pscychresns.2020.111107] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 03/24/2020] [Accepted: 04/15/2020] [Indexed: 10/24/2022]
Abstract
Early detection of Alzheimer's disease (AD) is important for timely interventions and developing new treatments. Hippocampus atrophy is an early biomarker of AD. The hippocampal parenchymal fraction (HPF) is a promising measure of hippocampal structural integrity computed from structural MRI. It is important to characterize the dependence of HPF on covariates such as age and sex in the normal population to enhance its utility as a disease biomarker. We measured the HPF in 4239 structural MRI scans from 340 cognitively normal (CN) subjects aged 59-89 years from the AD Neuroimaging Initiative database, and studied its dependence on age, sex, apolipoprotein E (APOE) genotype, brain hemisphere, intracranial volume (ICV), and education using a linear mixed-effects model. In this CN cohort, HPF was inversely associated with ICV; was greater on the right hemisphere compared to left in both sexes with the degree of right > left asymmetry being slightly more pronounced in men; declined quadratically with age and faster in APOE ϵ4 carriers compared to non-carriers; and was significantly associated with cognitive ability. Consideration of HPF as an AD biomarker should be in conjunction with other subject attributes that are shown in this research to influence HPF levels in CN older individuals.
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Affiliation(s)
- Babak A Ardekani
- Center for Brain Imaging and Neuromodulation, The Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY, USA; Department of Psychiatry, New York University School of Medicine, New York, NY, USA.
| | - Neema O Izadi
- Center for Brain Imaging and Neuromodulation, The Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY, USA
| | - Somar A Hadid
- Center for Brain Imaging and Neuromodulation, The Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY, USA
| | - Amir M Meftah
- Center for Brain Imaging and Neuromodulation, The Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY, USA
| | - Alvin H Bachman
- Center for Brain Imaging and Neuromodulation, The Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY, USA
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21
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Uddin MS, Rahman MM, Jakaria M, Rahman MS, Hossain MS, Islam A, Ahmed M, Mathew B, Omar UM, Barreto GE, Ashraf GM. Estrogen Signaling in Alzheimer's Disease: Molecular Insights and Therapeutic Targets for Alzheimer's Dementia. Mol Neurobiol 2020; 57:2654-2670. [PMID: 32297302 DOI: 10.1007/s12035-020-01911-8] [Citation(s) in RCA: 78] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Accepted: 03/23/2020] [Indexed: 01/04/2023]
Abstract
Estrogens play a crucial physiological function in the brain; however, debates exist concerning the role of estrogens in Alzheimer's disease (AD). Women during pre-, peri-, or menopause periods are more susceptible for developing AD, suggesting the connection of sex factors and a decreased estrogen signaling in AD pathogenesis. Yet, the underlying mechanism of estrogen-mediated neuroprotection is unclarified and is complicated by the existence of estrogen-related factors. Consequently, a deeper analysis of estrogen receptor (ER) expression and estrogen-metabolizing enzymes could interpret the importance of estrogen in age-linked cognitive alterations. Previous studies propose that hormone replacement therapy may attenuate AD onset in postmenopausal women, demonstrating that estrogen signaling is important for the development and progression of AD. For example, ERα exerts neuroprotection against AD by maintaining intracellular signaling cascades and study reported reduced expression of ERα in hippocampal neurons of AD patients. Similarly, reduced expression of ERβ in female AD patients has been associated with abnormal function in mitochondria and improved markers of oxidative stress. In this review, we discuss the critical interaction between estrogen signaling and AD. Moreover, we highlight the potential of targeting estrogen-related signaling for therapeutic intervention in AD.
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Affiliation(s)
- Md Sahab Uddin
- Department of Pharmacy, Southeast University, Dhaka, Bangladesh.
- Pharmakon Neuroscience Research Network, Dhaka, Bangladesh.
| | - Md Motiar Rahman
- Graduate School of Innovative Life Science, University of Toyama, Gofuku 3190, Toyama, 930-8555, Japan
| | - Md Jakaria
- The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Md Sohanur Rahman
- Graduate School of Innovative Life Science, University of Toyama, Gofuku 3190, Toyama, 930-8555, Japan
| | - Md Sarwar Hossain
- School of Biosciences and Veterinary Medicine, University of Camerino, Camerino, Italy
| | - Ariful Islam
- Department of Cell Biology and Neuroscience, Rowan University School of Osteopathic Medicine, Stratford, NJ, USA
| | - Muniruddin Ahmed
- Department of Pharmacy, Daffodil International University, Dhaka, Bangladesh
| | - Bijo Mathew
- Division of Drug Design and Medicinal Chemistry Research Lab, Department of Pharmaceutical Chemistry, Ahalia School of Pharmacy, Palakkad, India
| | - Ulfat Mohammed Omar
- Biochemistry Department, Faculty of Science, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
- Immunology Unit, King Fahad Medical Research Center, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
| | - George E Barreto
- Department of Biological Sciences, University of Limerick, Limerick, Ireland.
- Health Research Institute, University of Limerick, Limerick, Ireland.
| | - Ghulam Md Ashraf
- King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia.
- Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia.
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22
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Digma LA, Madsen JR, Rissman RA, Jacobs DM, Brewer JB, Banks SJ. Women can bear a bigger burden: ante- and post-mortem evidence for reserve in the face of tau. Brain Commun 2020; 2:fcaa025. [PMID: 32337508 PMCID: PMC7166251 DOI: 10.1093/braincomms/fcaa025] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 12/28/2019] [Accepted: 01/23/2020] [Indexed: 01/08/2023] Open
Abstract
In this study, we aimed to assess whether women are able to withstand more tau before exhibiting verbal memory impairment. Using data from 121 amyloid-β-positive Alzheimer’s Disease Neuroimaging Initiative participants, we fit a linear model with Rey Auditory Verbal Learning Test score as the response variable and tau-PET standard uptake value ratio as the predictor and took the residuals as an estimate of verbal memory reserve for each subject. Women demonstrated higher reserve (i.e. residuals), whether the Learning (t = 2.78, P = 0.006) or Delay (t = 2.14, P = 0.03) score from the Rey Auditory Verbal Learning Test was used as a measure of verbal memory ability. To validate these findings, we examined 662 National Alzheimer’s Coordinating Center participants with a C2/C3 score (Consortium to Establish a Registry for Alzheimer’s Disease) at autopsy. We stratified our National Alzheimer’s Coordinating Center sample into Braak 1/2, Braak 3/4 and Braak 5/6 subgroups. Within each subgroup, we compared Logical Memory scores between men and women. Men had worse verbal memory scores within the Braak 1/2 (Logical Memory Immediate: β = −5.960 ± 1.517, P < 0.001, Logical Memory Delay: β = −5.703 ± 1.677, P = 0.002) and Braak 3/4 (Logical Memory Immediate: β = −2.900 ± 0.938, P = 0.002, Logical Memory Delay: β = −2.672 ± 0.955, P = 0.006) subgroups. There were no sex differences in Logical Memory performance within the Braak 5/6 subgroup (Logical Memory Immediate: β = −0.314 ± 0.328, P = 0.34, Logical Memory Delay: β = −0.195 ± 0.287, P = 0.50). Taken together, our results point to a sex-related verbal memory reserve.
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Affiliation(s)
- Leonardino A Digma
- Department of Neurosciences, University of California San Diego, La Jolla, CA 92093, USA
| | - John R Madsen
- Department of Neurosciences, University of California San Diego, La Jolla, CA 92093, USA
| | - Robert A Rissman
- Department of Neurosciences, University of California San Diego, La Jolla, CA 92093, USA.,Veteran's Administration San Diego Healthcare System, La Jolla, CA 92093, USA
| | - Diane M Jacobs
- Department of Neurosciences, University of California San Diego, La Jolla, CA 92093, USA
| | - James B Brewer
- Department of Neurosciences, University of California San Diego, La Jolla, CA 92093, USA.,Department of Radiology, University of California San Diego, La Jolla, CA 92093, USA
| | - Sarah J Banks
- Department of Neurosciences, University of California San Diego, La Jolla, CA 92093, USA.,Department of Psychiatry, University of California San Diego, La Jolla, CA 92093, USA
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23
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Ferretti MT, Martinkova J, Biskup E, Benke T, Gialdini G, Nedelska Z, Rauen K, Mantua V, Religa D, Hort J, Santuccione Chadha A, Schmidt R. Sex and gender differences in Alzheimer's disease: current challenges and implications for clinical practice: Position paper of the Dementia and Cognitive Disorders Panel of the European Academy of Neurology. Eur J Neurol 2020; 27:928-943. [PMID: 32056347 DOI: 10.1111/ene.14174] [Citation(s) in RCA: 72] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Accepted: 02/11/2020] [Indexed: 12/13/2022]
Abstract
Alzheimer's disease (AD) is characterized by high heterogeneity in disease manifestation, progression and risk factors. High phenotypic variability is currently regarded as one of the largest hurdles in early diagnosis and in the design of clinical trials; there is therefore great interest in identifying factors driving variability that can be used for patient stratification. In addition to genetic and lifestyle factors, the individual's sex and gender are emerging as crucial drivers of phenotypic variability. Evidence exists on sex and gender differences in the rate of cognitive deterioration and brain atrophy, and in the effect of risk factors as well as in the patterns of diagnostic biomarkers. Such evidence might be of high relevance and requires attention in clinical practice and clinical trials. However, sex and gender differences are currently seldom appreciated; importantly, consideration of sex and gender differences is not currently a focus in the design and analysis of clinical trials for AD. The objective of this position paper is (i) to provide an overview of known sex and gender differences that might have implications for clinical practice, (ii) to identify the most important knowledge gaps in the field (with a special regard to clinical trials) and (iii) to provide conclusions for future studies. This scientific statement is endorsed by the European Academy of Neurology.
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Affiliation(s)
- M T Ferretti
- Institute for Regenerative Medicine - IREM, University of Zurich, Zurich, Switzerland.,Women's Brain Project, Guntershausen, Switzerland
| | - J Martinkova
- Memory Clinic, Department of Neurology, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
| | - E Biskup
- College of Fundamental Medicine, Shanghai University of Medicine and Health Sciences, Shanghai, China.,Division of Internal Medicine, University Hospital of Basel, Basel, Switzerland
| | - T Benke
- Neurology Clinic, Medical University Innsbruck, Innsbruck, Austria
| | - G Gialdini
- Neurology - Private Practice, Lucca, Italy
| | - Z Nedelska
- Memory Clinic, Department of Neurology, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic.,International Clinical Research Center, St Anne's University Hospital Brno, Brno, Czech Republic
| | - K Rauen
- Institute for Regenerative Medicine - IREM, University of Zurich, Zurich, Switzerland.,Women's Brain Project, Guntershausen, Switzerland.,Department of Geriatric Psychiatry, University Hospital of Psychiatry Zurich, Zurich, Switzerland
| | - V Mantua
- Italian Medicines Agency, Rome, Italy
| | - D Religa
- Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Stockholm, Sweden
| | - J Hort
- Memory Clinic, Department of Neurology, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic.,International Clinical Research Center, St Anne's University Hospital Brno, Brno, Czech Republic
| | - A Santuccione Chadha
- Women's Brain Project, Guntershausen, Switzerland.,Global Medical and Scientific Affairs, Roche Diagnostics International Ltd, Rotkreuz, Switzerland
| | - R Schmidt
- Department of Neurogeriatrics, University Clinic of Neurology, Medical University Graz, Graz, Austria
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24
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Brunet HE, Caldwell JZK, Brandt J, Miller JB. Influence of sex differences in interpreting learning and memory within a clinical sample of older adults. AGING NEUROPSYCHOLOGY AND COGNITION 2019; 27:18-39. [PMID: 30663493 DOI: 10.1080/13825585.2019.1566433] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Sex is an important factor to consider when evaluating memory with older adults. This present study aimed to examine sex differences in memory within a clinical sample of older adults (N = 1084). Raw learning and recall scores on the Hopkins Verbal Learning Test, Revised (HVLT-R) and Brief Visuospatial Memory Test, Revised (BVMT-R) were compared between sexes within the entire sample and cohorts stratified by age. Within the entire sample, women outperformed men in HVLT-R learning and recall, and there were no sex differences in BVMT-R performance. These sex differences, however, were absent or reversed for those with impaired HVLT-R performance and functional deficits, indicating that women retain an early advantage in verbal memory, which is lost with greater indication of disease severity. These findings indicate that women retain an advantage in verbal learning and memory, at least before significant levels of impairment, within a sample of older adults seen at an outpatient neurology clinic, which may have implications for diagnosing memory disorders.
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Affiliation(s)
- Hannah E Brunet
- Neurological Institute, Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas, USA
| | - Jessica Z K Caldwell
- Neurological Institute, Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas, USA
| | - Jason Brandt
- Department of Psychiatry and Behavioral Sciences, Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, USA
| | - Justin B Miller
- Neurological Institute, Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas, USA
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25
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Sundermann EE, Edmonds EC, Delano-Wood L, Galasko DR, Salmon DP, Rubin LH, Bondi MW. Sex Influences the Accuracy of Subjective Memory Complaint Reporting in Older Adults. J Alzheimers Dis 2019; 61:1163-1178. [PMID: 29332038 DOI: 10.3233/jad-170425] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Subjective memory complaints (SMC) are required when diagnosing amnestic mild cognitive impairment (aMCI), although their relationship with objective memory performance and Alzheimer's disease (AD) pathology remains unclear. We investigated whether the sex of the patient/participant moderates these associations. Participants were 940 normal control (NC) and aMCI participants from the Alzheimer's Disease Neuroimaging Initiative. SMC were assessed via the memory scale of the Everyday Cognition questionnaire. Discrepancy scores were calculated between self- and informant-reports and categorized into "overestimates," "comparable estimates", and "underestimates" of SMC. We conducted linear and logistic regressions to examine the interaction of sex with self- and informant-reported SMC and discrepancy group on the Rey Auditory Verbal Learning Test (RAVLT) Immediate and Delayed Recall and on PET measures of amyloid-β (Aβ) positivity. Diagnosis-stratified analyses were also conducted. Overall, there were sex by self- and informant-reported SMC interactions for Immediate and Delayed Recall. Despite a higher proportion of "overestimates" in women, greater self- and informant-reported SMC showed a stronger relationship to poorer RAVLT scores in women versus men. Diagnosis-stratified analyses revealed that results were driven by aMCI participants. Conversely, overall, greater self- and informant-reported SMC related to greater odds of Aβ positivity regardless of sex. In diagnosis-stratified analyses, only informant-reported SMC related to Aβ positivity in aMCI. Relative to "comparable estimates," "underestimates" of SMC were associated with poorer RAVLT scores across sexes in the overall sample and in aMCI. The predictive utility of self-report SMC may be limited to women in aMCI. Sex differences should be considered when evaluating SMC.
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Affiliation(s)
- Erin E Sundermann
- Department of Psychiatry, University of California, La Jolla, CA, USA
| | - Emily C Edmonds
- Department of Psychiatry, University of California, La Jolla, CA, USA.,VA San Diego Healthcare System, San Diego, CA, USA
| | - Lisa Delano-Wood
- Department of Psychiatry, University of California, La Jolla, CA, USA.,VA San Diego Healthcare System, San Diego, CA, USA
| | - Douglas R Galasko
- VA San Diego Healthcare System, San Diego, CA, USA.,Department of Neurosciences, University of California, San Diego, La Jolla, CA, USA
| | - David P Salmon
- Department of Neurosciences, University of California, San Diego, La Jolla, CA, USA
| | - Leah H Rubin
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA
| | - Mark W Bondi
- Department of Psychiatry, University of California, La Jolla, CA, USA.,VA San Diego Healthcare System, San Diego, CA, USA
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26
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Andrew MK, Tierney MC. The puzzle of sex, gender and Alzheimer’s disease: Why are women more often affected than men? WOMENS HEALTH 2018. [PMCID: PMC6311541 DOI: 10.1177/1745506518817995] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Objective: There are impressive differences in the incidence, prevalence and experience of women and men with Alzheimer’s Disease (AD). Notably, two-thirds of those with AD, the most common form of dementia, are women. Our objective was to provide a literature-based framework to understand these sex and gender differences in AD. Methods: We conducted a narrative review to examine sex and gender influences on AD. Results: We present a framework to understanding why these sex and gender differences exist in AD. This includes the influence of longevity (women live longer than men), biological differences (hormonal differences, epigenetics and frailty), differences in cognitive performance (women and men tend to perform differently on some cognitive tests), and gendered social roles and opportunities (educational and occupational opportunities, functional roles post-retirement). Our review clearly indicates the complex interaction of these sex and gender differences and variability within each. Conclusions: Given these important sex and gender differences in AD, we provide recommendations and steps forward describing how both sex and gender should be considered in dementia diagnosis and management and in the design and implementation of dementia research, including studies of caregiving interventions and models of dementia care.
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Affiliation(s)
- Melissa K Andrew
- Division of Geriatric Medicine, Dalhousie University, Halifax, NS, Canada
| | - Mary C Tierney
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
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27
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Duarte A, Santos M, Oliveira C, Moreira P. Brain insulin signalling, glucose metabolism and females' reproductive aging: A dangerous triad in Alzheimer's disease. Neuropharmacology 2018; 136:223-242. [DOI: 10.1016/j.neuropharm.2018.01.044] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Revised: 01/22/2018] [Accepted: 01/29/2018] [Indexed: 12/12/2022]
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28
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Yao Q, Feng M, Yang B, Long Z, Luo S, Luo M, He G, Wang K. Effects of ovarian hormone loss on neuritic plaques and autophagic flux in the brains of adult female APP/PS1 double-transgenic mice. Acta Biochim Biophys Sin (Shanghai) 2018; 50:447-455. [PMID: 29617703 PMCID: PMC5946928 DOI: 10.1093/abbs/gmy032] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Accepted: 03/07/2018] [Indexed: 01/07/2023] Open
Abstract
Epidemiologic studies have demonstrated that women account for two-thirds of Alzheimer’s disease (AD) cases, for which the decline in circulating gonadal hormone is considered to be one of the major risk factors. In addition, ovarian hormone deficiency may affect β-amyloid (Aβ) deposition, which has a close relationship with autophagic flux. In this study, we investigated the impact of short-term or long-term ovarian hormone deprivation on two mouse models, the non-transgenic (wild-type) and the APP/PS1 double-transgenic AD (2×TgAD) model. Autophagy-related proteins (Beclin1, LC3, and p62) and lysosome-related proteins were detected to evaluate Aβ deposition and autophagy. Our results showed that in the group with short-term depletion of ovarian hormones by ovariectomy (ovx), Beclin1, Cathepsin B (Cath-B), and LAMP1 levels were significantly decreased, while the levels of LC3-II and p62 were increased. In the long-term group, however, there was a sharp decline in Beclin1, LC3-II, Cath-B, and LAMP1 expression but not in p62 expression which is increased. It is worthwhile to note that the occurrence of neuritic plaque-induced ovarian hormone loss increased both the Aβ level and neuritic plaque deposition in 2×TgAD mice. Therefore, autophagy may play an important role in the pathogenesis of female AD, which is also expected to help post-menopausal patients with AD.
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Affiliation(s)
- Qiuhui Yao
- Chongqing Key Laboratory of Neurobiology, Basic Medical College, Chongqing Medical University, Chongqing 400016, China
- Department of Obstetrics and Gynecology, The Affiliated Hospital of Southwest Medical University, Luzhou 646000, China
| | - Min Feng
- Chongqing Key Laboratory of Neurobiology, Basic Medical College, Chongqing Medical University, Chongqing 400016, China
| | - Bo Yang
- Chongqing Key Laboratory of Neurobiology, Basic Medical College, Chongqing Medical University, Chongqing 400016, China
| | - Zhimin Long
- Chongqing Key Laboratory of Neurobiology, Basic Medical College, Chongqing Medical University, Chongqing 400016, China
| | - Shifang Luo
- Chongqing Key Laboratory of Neurobiology, Basic Medical College, Chongqing Medical University, Chongqing 400016, China
| | - Min Luo
- Chongqing Key Laboratory of Neurobiology, Basic Medical College, Chongqing Medical University, Chongqing 400016, China
| | - Guiqiong He
- Chongqing Key Laboratory of Neurobiology, Basic Medical College, Chongqing Medical University, Chongqing 400016, China
- Department of Anatomy, Basic Medical College, Chongqing Medical University, Chongqing 400016, China
| | - Kejian Wang
- Chongqing Key Laboratory of Neurobiology, Basic Medical College, Chongqing Medical University, Chongqing 400016, China
- Department of Anatomy, Basic Medical College, Chongqing Medical University, Chongqing 400016, China
- Correspondence address. Tel: +86-23-68485763; Fax: +86-23-68485000; E-mail:
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29
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Brooks SW, Dykes AC, Schreurs BG. A High-Cholesterol Diet Increases 27-Hydroxycholesterol and Modifies Estrogen Receptor Expression and Neurodegeneration in Rabbit Hippocampus. J Alzheimers Dis 2018; 56:185-196. [PMID: 27911307 DOI: 10.3233/jad-160725] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Hypercholesterolemia has been implicated in numerous health problems from cardiovascular disease to neurodegeneration. High serum cholesterol levels in midlife have been associated with an increased risk of developing Alzheimer's disease (AD) later in life which suggests that the pathways leading to AD pathology might be activated decades before the symptoms of the disease are detected. Cholesterol-fed animals, particularly cholesterol-fed rabbits, exhibit brain pathology similar to the changes found in brains of AD patients. Dietary cholesterol, which cannot pass the blood-brain barrier, is thought to influence central nervous system homeostasis by increased transport of its circulatory breakdown product, 27-hydroxycholesterol (27-OHC), into the brain. 27-OHC is an endogenous selective estrogen receptor modulator. Estrogen-mediated non-reproductive functions require estrogen receptors (ERs) and include modulation of mitochondrial function and structure, as well as regulation of synaptogenesis in the brain. ERs are located in brain areas affected early in AD pathogenesis, including the hippocampus. Here we report that increase in serum cholesterol, induced by feeding rabbits a high-cholesterol diet, is associated with higher levels of 27-OHC in the brain as well as increased levels of neurodegeneration in the hippocampus. Furthermore, these results are accompanied by changes in expression of ERs in the hippocampus as well as a decrease in hippocampal mitochondria. These findings provide an important insight into one of the possible mechanisms involved in the development of AD, and shed light on the processes that may antedate amyloid-β and tau phosphorylation changes currently hypothesized to cause AD symptomology and pathology.
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Affiliation(s)
- Sylwia W Brooks
- School of Medicine, West Virginia University, Morgantown, WV, USA.,Blanchette Rockefeller Neurosciences Institute, Morgantown, WV, USA
| | - Ava C Dykes
- Molecular Biology Core Facility, Centers for Disease Control and Prevention/National Institute for Occupational Safety and Health, Morgantown, WV, USA
| | - Bernard G Schreurs
- School of Medicine, West Virginia University, Morgantown, WV, USA.,Blanchette Rockefeller Neurosciences Institute, Morgantown, WV, USA
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30
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Sundermann EE, Biegon A, Rubin LH, Lipton RB, Landau S, Maki PM. Does the Female Advantage in Verbal Memory Contribute to Underestimating Alzheimer's Disease Pathology in Women versus Men? J Alzheimers Dis 2018; 56:947-957. [PMID: 28106548 DOI: 10.3233/jad-160716] [Citation(s) in RCA: 99] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
There is a growing recognition of sex differences in Alzheimer's disease (AD). Females show an advantage over males on tests of verbal memory, which are used to diagnose AD and its precursor, amnestic mild cognitive impairment (aMCI). Women retain this advantage in aMCI despite reduced hippocampal volume and temporal lobe glucose metabolism. Here we examined whether this female advantage endures despite evidence of AD-specific pathology, cortical amyloid-β (Aβ) deposition measured with [18F]AV45 (florbetapir) positron emission tomography. Participants with normal cognition (N = 304), aMCI (N = 515), and AD dementia (N = 175) were drawn from the Alzheimer's Disease Neuroimaging Initiative (ADNI). Across and within diagnostic groups, we conducted linear regressions to examine the interaction of sex with cortical Aβ burden on immediate and delayed recall on the Rey Auditory Verbal Learning Test (RAVLT) adjusting for age, education, and APOE4. In the overall group, sex by cortical Aβ interaction was significant for delayed recall only. Overall, delayed recall performance was significantly better in women versus men among those with low to moderate Aβ burden, but women and men performed similarly among those with high Aβ burden. In diagnosis-stratified analyses, a significant sex by cortical Aβ interaction was observed for delayed recall in the aMCI group, but not in the normal or AD dementia groups. Thus, women maintain a verbal memory advantage over men in aMCI despite similar levels of AD pathology. Although this advantage may benefit women by delaying verbal memory impairment until more advanced pathology, it may also delay diagnosis of aMCI and treatment intervention.
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Affiliation(s)
- Erin E Sundermann
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - Anat Biegon
- Department of Neurology, State University of New York, New York, NY, USA
| | - Leah H Rubin
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA
| | - Richard B Lipton
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - Susan Landau
- Einstein Aging Study and the Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Pauline M Maki
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA
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31
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Ryan JJ, Glass Umfleet L, Kreiner DS, Fuller AM, Paolo AM. Neuropsychological differences between men and women with Alzheimer's disease. Int J Neurosci 2018; 128:342-348. [DOI: 10.1080/00207454.2017.1382492] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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32
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Geary DC. Evolution of Human Sex-Specific Cognitive Vulnerabilities. QUARTERLY REVIEW OF BIOLOGY 2017. [DOI: 10.1086/694934] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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33
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Li F, Takechi H, Kokuryu A, Takahashi R. Longitudinal Changes in Performance on Cognitive Screening Tests in Patients with Mild Cognitive Impairment and Alzheimer Disease. Dement Geriatr Cogn Dis Extra 2017; 7:366-373. [PMID: 29282409 PMCID: PMC5731165 DOI: 10.1159/000481910] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Revised: 09/30/2017] [Indexed: 11/19/2022] Open
Abstract
Background Neuropsychological tests that can track changes in cognitive functions after diagnosis of Alzheimer disease (AD) and mild cognitive impairment (MCI), including episodic memory, should be further developed. Methods The participants of our study consisted of 22 mild AD patients and 11 MCI patients. They were followed up for 2 years. Brief cognitive screening tests were administered to the participants. Longitudinal changes in test performance were evaluated and analyzed. Results In this longitudinal study, the Scenery Picture Memory Test (SPMT) showed significant changes over 2 years in both MCI and AD participants. The Mini-Mental State Examination (MMSE) and Word Fluency Test-vegetable showed significant changes only in AD participants. Other tests all showed little or no decline in results. Conclusions The SPMT can be a useful tool for effectively observing changes during follow-up of MCI and AD patients.
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Affiliation(s)
- Fangzhou Li
- Department of Neurology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Hajime Takechi
- Department of Neurology, Kyoto University Graduate School of Medicine, Kyoto, Japan.,Department of Geriatrics and Cognitive Disorders, Fujita Health University School of Medicine, Toyoake, Japan
| | - Atsuko Kokuryu
- Department of Neurology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Ryosuke Takahashi
- Department of Neurology, Kyoto University Graduate School of Medicine, Kyoto, Japan
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Gobinath AR, Choleris E, Galea LA. Sex, hormones, and genotype interact to influence psychiatric disease, treatment, and behavioral research. J Neurosci Res 2016; 95:50-64. [DOI: 10.1002/jnr.23872] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2016] [Revised: 07/08/2016] [Accepted: 07/14/2016] [Indexed: 12/17/2022]
Affiliation(s)
- Aarthi R. Gobinath
- Centre for Brain Health, Program in Neuroscience; University of British Columbia; Vancouver British Columbia V6T1Z3 Canada
| | - Elena Choleris
- Department of Psychology; University of Guelph; Guelph Ontario N1G 2W1 Canada
| | - Liisa A.M. Galea
- Centre for Brain Health, Program in Neuroscience; University of British Columbia; Vancouver British Columbia V6T1Z3 Canada
- Department of Psychology; University of British Columbia; Vancouver British Columbia V6T1Z3 Canada
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Sundermann EE, Maki PM, Rubin LH, Lipton RB, Landau S, Biegon A. Female advantage in verbal memory: Evidence of sex-specific cognitive reserve. Neurology 2016; 87:1916-1924. [PMID: 27708128 DOI: 10.1212/wnl.0000000000003288] [Citation(s) in RCA: 147] [Impact Index Per Article: 18.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Accepted: 07/14/2016] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE We investigated sex differences in verbal memory across different levels of neural dysfunction, measured by temporal lobe glucose metabolic rates (TLGluMR). METHODS Three hundred ninety controls and 672 participants with amnestic mild cognitive impairment (aMCI) and 254 with Alzheimer disease (AD) dementia from the Alzheimer's Disease Neuroimaging Initiative completed the Rey Auditory Verbal Learning Test (RAVLT) and [18F]-fluorodeoxyglucose-PET. Cross-sectional analyses were conducted using linear regression to examine the sex by TLGluMR interaction on RAVLT performance in the overall sample and within diagnostic groups adjusting for age, education, and APOE ε4 genotype. RESULTS Across groups, female sex and higher TLGluMR and their interaction were associated with better verbal memory (p values ≤ 0.005). The female advantage in verbal memory varied by TLGluMR such that the advantage was greatest among individuals with moderate to high TLGluMR and minimal or absent among individuals with lower TLGluMR. Diagnosis-stratified analyses revealed that this interaction was driven by the aMCI group (p values = 0.009). The interaction was not significant in control and AD dementia groups. CONCLUSIONS Women show better verbal memory than men in aMCI despite similar levels of brain hypometabolism. The lifelong advantage that females show over males in verbal memory might represent a form of cognitive reserve that delays verbal memory decline until more advanced pathology, as indexed by TLGluMR. This issue is clinically important because verbal memory scores are used in diagnosing aMCI and AD dementia.
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Affiliation(s)
- Erin E Sundermann
- From the Einstein Aging Study and the Department of Neurology (E.E.S., R.B.L.), Albert Einstein College of Medicine, Bronx, NY; Department of Psychiatry (P.M.M., L.H.R.), University of Illinois at Chicago; Helen Wills Neuroscience Institute (S.L.), University of California, Berkeley; and Department of Neurology (A.B.), State University of New York, Stony Brook.
| | - Pauline M Maki
- From the Einstein Aging Study and the Department of Neurology (E.E.S., R.B.L.), Albert Einstein College of Medicine, Bronx, NY; Department of Psychiatry (P.M.M., L.H.R.), University of Illinois at Chicago; Helen Wills Neuroscience Institute (S.L.), University of California, Berkeley; and Department of Neurology (A.B.), State University of New York, Stony Brook
| | - Leah H Rubin
- From the Einstein Aging Study and the Department of Neurology (E.E.S., R.B.L.), Albert Einstein College of Medicine, Bronx, NY; Department of Psychiatry (P.M.M., L.H.R.), University of Illinois at Chicago; Helen Wills Neuroscience Institute (S.L.), University of California, Berkeley; and Department of Neurology (A.B.), State University of New York, Stony Brook
| | - Richard B Lipton
- From the Einstein Aging Study and the Department of Neurology (E.E.S., R.B.L.), Albert Einstein College of Medicine, Bronx, NY; Department of Psychiatry (P.M.M., L.H.R.), University of Illinois at Chicago; Helen Wills Neuroscience Institute (S.L.), University of California, Berkeley; and Department of Neurology (A.B.), State University of New York, Stony Brook
| | - Susan Landau
- From the Einstein Aging Study and the Department of Neurology (E.E.S., R.B.L.), Albert Einstein College of Medicine, Bronx, NY; Department of Psychiatry (P.M.M., L.H.R.), University of Illinois at Chicago; Helen Wills Neuroscience Institute (S.L.), University of California, Berkeley; and Department of Neurology (A.B.), State University of New York, Stony Brook
| | - Anat Biegon
- From the Einstein Aging Study and the Department of Neurology (E.E.S., R.B.L.), Albert Einstein College of Medicine, Bronx, NY; Department of Psychiatry (P.M.M., L.H.R.), University of Illinois at Chicago; Helen Wills Neuroscience Institute (S.L.), University of California, Berkeley; and Department of Neurology (A.B.), State University of New York, Stony Brook
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Fengler S, Roeske S, Heber I, Reetz K, Schulz JB, Riedel O, Wittchen HU, Storch A, Linse K, Baudrexel S, Hilker R, Mollenhauer B, Witt K, Schmidt N, Balzer-Geldsetzer M, Dams J, Dodel R, Gräber S, Pilotto A, Petrelli A, Fünkele S, Kassubek J, Kalbe E. Verbal memory declines more in female patients with Parkinson's disease: the importance of gender-corrected normative data. Psychol Med 2016; 46:2275-2286. [PMID: 27193073 DOI: 10.1017/s0033291716000908] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Data on gender-specific profiles of cognitive functions in patients with Parkinson's disease (PD) are rare and inconsistent, and possible disease-confounding factors have been insufficiently considered. METHOD The LANDSCAPE study on cognition in PD enrolled 656 PD patients (267 without cognitive impairment, 66% male; 292 with mild cognitive impairment, 69% male; 97 with PD dementia, 69% male). Raw values and age-, education-, and gender-corrected Z scores of a neuropsychological test battery (CERAD-Plus) were compared between genders. Motor symptoms, disease duration, l-dopa equivalent daily dose, depression - and additionally age and education for the raw value analysis - were taken as covariates. RESULTS Raw-score analysis replicated results of previous studies in that female PD patients were superior in verbal memory (word list learning, p = 0.02; recall, p = 0.03), while men outperformed women in visuoconstruction (p = 0.002) and figural memory (p = 0.005). In contrast, gender-corrected Z scores showed that men were superior in verbal memory (word list learning, p = 0.02; recall, p = 0.02; recognition, p = 0.04), while no difference was found for visuospatial tests. This picture could be observed both in the overall analysis of PD patients as well as in a differentiated group analysis. CONCLUSIONS Normative data corrected for gender and other sociodemographic variables are relevant, since they may elucidate a markedly different cognitive profile compared to raw scores. Our study also suggests that verbal memory decline is stronger in women than in men with PD. Future studies are needed to replicate these findings, examine the progression of gender-specific cognitive decline in PD and define different underlying mechanisms of this dysfunction.
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Affiliation(s)
- S Fengler
- Department of Medical Psychology,University Hospital Cologne,Germany
| | - S Roeske
- Department of Neurology,University Hospital Bonn, and German Center for Neurodegenerative Diseases (DZNE),Bonn,Germany
| | - I Heber
- Department of Neurology,Medical Faculty,RWTH Aachen University,Germany
| | - K Reetz
- Department of Neurology,Medical Faculty,RWTH Aachen University,Germany
| | - J B Schulz
- Department of Neurology,Medical Faculty,RWTH Aachen University,Germany
| | - O Riedel
- Leibniz-Institute of Prevention Research and Epidemiology,Department of Clinical Epidemiology,Bremen,Germany
| | - H U Wittchen
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden,Germany
| | - A Storch
- Division of Neurodegenerative Diseases,Department of Neurology,Technische Universität Dresden,Germany
| | - K Linse
- Division of Neurodegenerative Diseases,Department of Neurology,Technische Universität Dresden,Germany
| | - S Baudrexel
- Department of Neurology,J.W. Goethe University,Frankfurt/Main,Germany
| | - R Hilker
- Department of Neurology,J.W. Goethe University,Frankfurt/Main,Germany
| | - B Mollenhauer
- Department of Neuropathology,University Medical Center Goettingen,Germany
| | - K Witt
- Department of Neurology,Christian Albrechts University,Kiel,Germany
| | - N Schmidt
- Department of Neurology,Christian Albrechts University,Kiel,Germany
| | | | - J Dams
- Department of Neurology,Philipps University Marburg,Germany
| | - R Dodel
- Department of Neurology,Philipps University Marburg,Germany
| | - S Gräber
- Department of Neurodegenerative Diseases,Hertie Institute for Clinical Brain Research and German Center for Neurodegenerative Diseases (DZNE), University Tübingen, and German Center for Neurodegenerative Diseases, Tübingen,Germany
| | - A Pilotto
- Department of Neurodegenerative Diseases,Hertie Institute for Clinical Brain Research and German Center for Neurodegenerative Diseases (DZNE), University Tübingen, and German Center for Neurodegenerative Diseases, Tübingen,Germany
| | - A Petrelli
- Institute of Gerontology & Center for Neuropsychological Diagnostics and Intervention (CeNDI), University of Vechta,Germany
| | - S Fünkele
- Department of Neurology,University of Ulm,Germany
| | - J Kassubek
- Department of Neurology,University of Ulm,Germany
| | - E Kalbe
- Department of Medical Psychology,University Hospital Cologne,Germany
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Hamson DK, Roes MM, Galea LAM. Sex Hormones and Cognition: Neuroendocrine Influences on Memory and Learning. Compr Physiol 2016; 6:1295-337. [DOI: 10.1002/cphy.c150031] [Citation(s) in RCA: 118] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Laws KR, Irvine K, Gale TM. Sex differences in cognitive impairment in Alzheimer’s disease. World J Psychiatry 2016; 6:54-65. [PMID: 27014598 PMCID: PMC4804268 DOI: 10.5498/wjp.v6.i1.54] [Citation(s) in RCA: 200] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Revised: 11/14/2015] [Accepted: 01/22/2016] [Indexed: 02/05/2023] Open
Abstract
Sex differences in neurocognitive abilities have been extensively explored both in the healthy population and in many disorders. Until recently, however, little work has examined such differences in people with Alzheimer’s disease (AD). This is despite clear evidence that AD is more prevalent in women, and converging lines of evidence from brain imaging, post-mortem analyses, hormone therapy and genetics suggesting that AD affects men and women differently. We provide an overview of evidence attesting to the poorer cognitive profiles in women than in men at the same stage of AD. Indeed, men significantly outperform women in several cognitive domains, including: Language and semantic abilities, visuospatial abilities and episodic memory. These differences do not appear to be attributable to any differences in age, education, or dementia severity. Reasons posited for this female disadvantage include a reduction of estrogen in postmenopausal women, greater cognitive reserve in men, and the influence of the apolipoprotein E ε4 allele. Assessment of cognitive abilities contributes to the diagnosis of the condition and thus, it is crucial to identify the role of sex differences if potentially more accurate diagnoses and treatments are to emerge.
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Sundermann EE, Biegon A, Rubin LH, Lipton RB, Mowrey W, Landau S, Maki PM. Better verbal memory in women than men in MCI despite similar levels of hippocampal atrophy. Neurology 2016; 86:1368-1376. [PMID: 26984945 DOI: 10.1212/wnl.0000000000002570] [Citation(s) in RCA: 125] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Accepted: 10/26/2015] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To examine sex differences in the relationship between clinical symptoms related to Alzheimer disease (AD) (verbal memory deficits) and neurodegeneration (hippocampal volume/intracranial volume ratio [HpVR]) across AD stages. METHODS The sample included 379 healthy participants, 694 participants with amnestic mild cognitive impairment (aMCI), and 235 participants with AD and dementia from the Alzheimer's Disease Neuroimaging Initiative who completed the Rey Auditory Verbal Learning Test (RAVLT). Cross-sectional analyses were conducted using linear regression to examine the interaction between sex and HpVR on RAVLT across and within diagnostic groups adjusting for age, education, and APOE ε4 status. RESULTS Across groups, there were significant sex × HpVR interactions for immediate and delayed recall (p < 0.01). Women outperformed men among individuals with moderate to larger HpVR, but not among individuals with smaller HpVR. In diagnosis-stratified analyses, the HpVR × sex interaction was significant in the aMCI group, but not in the control or AD dementia groups, for immediate and delayed recall (p < 0.01). Among controls, women outperformed men on both outcomes irrespective of HpVR (p < 0.001). In AD dementia, better RAVLT performance was independently associated with female sex (immediate, p = 0.04) and larger HpVR (delayed, p = 0.001). CONCLUSION Women showed an advantage in verbal memory despite evidence of moderate hippocampal atrophy. This advantage may represent a sex-specific form of cognitive reserve delaying verbal memory decline until more advanced disease stages.
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Affiliation(s)
- Erin E Sundermann
- From the Einstein Aging Study and the Department of Neurology (E.E.S., R.B.L.) and the Department of Epidemiology and Population Health (W.M.), Albert Einstein College of Medicine, Bronx; Department of Neurology (A.B.), State University of New York, Stony Brook; Department of Psychiatry (L.H.R., P.M.M.), University of Illinois at Chicago; and Helen Wills Neuroscience Institute (S.L.), University of California, Berkeley.
| | - Anat Biegon
- From the Einstein Aging Study and the Department of Neurology (E.E.S., R.B.L.) and the Department of Epidemiology and Population Health (W.M.), Albert Einstein College of Medicine, Bronx; Department of Neurology (A.B.), State University of New York, Stony Brook; Department of Psychiatry (L.H.R., P.M.M.), University of Illinois at Chicago; and Helen Wills Neuroscience Institute (S.L.), University of California, Berkeley
| | - Leah H Rubin
- From the Einstein Aging Study and the Department of Neurology (E.E.S., R.B.L.) and the Department of Epidemiology and Population Health (W.M.), Albert Einstein College of Medicine, Bronx; Department of Neurology (A.B.), State University of New York, Stony Brook; Department of Psychiatry (L.H.R., P.M.M.), University of Illinois at Chicago; and Helen Wills Neuroscience Institute (S.L.), University of California, Berkeley
| | - Richard B Lipton
- From the Einstein Aging Study and the Department of Neurology (E.E.S., R.B.L.) and the Department of Epidemiology and Population Health (W.M.), Albert Einstein College of Medicine, Bronx; Department of Neurology (A.B.), State University of New York, Stony Brook; Department of Psychiatry (L.H.R., P.M.M.), University of Illinois at Chicago; and Helen Wills Neuroscience Institute (S.L.), University of California, Berkeley
| | - Wenzhu Mowrey
- From the Einstein Aging Study and the Department of Neurology (E.E.S., R.B.L.) and the Department of Epidemiology and Population Health (W.M.), Albert Einstein College of Medicine, Bronx; Department of Neurology (A.B.), State University of New York, Stony Brook; Department of Psychiatry (L.H.R., P.M.M.), University of Illinois at Chicago; and Helen Wills Neuroscience Institute (S.L.), University of California, Berkeley
| | - Susan Landau
- From the Einstein Aging Study and the Department of Neurology (E.E.S., R.B.L.) and the Department of Epidemiology and Population Health (W.M.), Albert Einstein College of Medicine, Bronx; Department of Neurology (A.B.), State University of New York, Stony Brook; Department of Psychiatry (L.H.R., P.M.M.), University of Illinois at Chicago; and Helen Wills Neuroscience Institute (S.L.), University of California, Berkeley
| | - Pauline M Maki
- From the Einstein Aging Study and the Department of Neurology (E.E.S., R.B.L.) and the Department of Epidemiology and Population Health (W.M.), Albert Einstein College of Medicine, Bronx; Department of Neurology (A.B.), State University of New York, Stony Brook; Department of Psychiatry (L.H.R., P.M.M.), University of Illinois at Chicago; and Helen Wills Neuroscience Institute (S.L.), University of California, Berkeley
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Zhao L, Mao Z, Woody SK, Brinton RD. Sex differences in metabolic aging of the brain: insights into female susceptibility to Alzheimer's disease. Neurobiol Aging 2016; 42:69-79. [PMID: 27143423 DOI: 10.1016/j.neurobiolaging.2016.02.011] [Citation(s) in RCA: 96] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Revised: 02/08/2016] [Accepted: 02/10/2016] [Indexed: 10/22/2022]
Abstract
Despite recent advances in the understanding of clinical aspects of sex differences in Alzheimer's disease (AD), the underlying mechanisms, for instance, how sex modifies AD risk and why the female brain is more susceptible to AD, are not clear. The purpose of this study is to elucidate sex disparities in brain aging profiles focusing on 2 major areas-energy and amyloid metabolism-that are most significantly affected in preclinical development of AD. Total RNA isolated from hippocampal tissues of both female and male 129/C57BL/6 mice at ages of 6, 9, 12, or 15 months were comparatively analyzed by custom-designed Taqman low-density arrays for quantitative real-time polymerase chain reaction detection of a total of 182 genes involved in a broad spectrum of biological processes modulating energy production and amyloid homeostasis. Gene expression profiles revealed substantial differences in the trajectory of aging changes between female and male brains. In female brains, 44.2% of genes were significantly changed from 6 months to 9 months and two-thirds showed downregulation. In contrast, in male brains, only 5.4% of genes were significantly altered at this age transition. Subsequent changes in female brains were at a much smaller magnitude, including 10.9% from 9 months to 12 months and 6.1% from 12 months to 15 months. In male brains, most changes occurred from 12 months to 15 months and the majority were upregulated. Furthermore, gene network analysis revealed that clusterin appeared to serve as a link between the overall decreased bioenergetic metabolism and increased amyloid dyshomeostasis associated with the earliest transition in female brains. Together, results from this study indicate that: (1) female and male brains follow profoundly dissimilar trajectories as they age; (2) female brains undergo age-related changes much earlier than male brains; (3) early changes in female brains signal the onset of a hypometabolic phenotype at risk for AD. These findings provide a mechanistic rationale for female susceptibility to AD and suggest a potential window of opportunity for AD prevention and risk reduction in women.
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Affiliation(s)
- Liqin Zhao
- Department of Pharmacology and Toxicology, School of Pharmacy, University of Kansas, Lawrence, KS, USA; Neuroscience Graduate Program, University of Kansas, Lawrence, KS, USA; Department of Pharmacology and Pharmaceutical Sciences, School of Pharmacy, University of Southern California, Los Angeles, CA, USA.
| | - Zisu Mao
- Department of Pharmacology and Pharmaceutical Sciences, School of Pharmacy, University of Southern California, Los Angeles, CA, USA
| | - Sarah K Woody
- Department of Pharmacology and Toxicology, School of Pharmacy, University of Kansas, Lawrence, KS, USA
| | - Roberta D Brinton
- Department of Pharmacology and Pharmaceutical Sciences, School of Pharmacy, University of Southern California, Los Angeles, CA, USA; Department of Neurology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
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Gale SD, Baxter L, Thompson J. Greater memory impairment in dementing females than males relative to sex-matched healthy controls. J Clin Exp Neuropsychol 2016; 38:527-33. [PMID: 26735615 DOI: 10.1080/13803395.2015.1132298] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Previously we demonstrated sex differences in episodic memory in healthy elderly and suggested that normative data be separated by sex. The present study extended the exploration of sex differences on memory measures into two clinical populations, mild cognitive impairment (MCI) and Alzheimer's disease (AD). Seventy-six subjects with MCI and 101 subjects with AD diagnosed by a multidisciplinary team were included. These two groups were also compared to a group of 177 healthy elderly control participants. Sex differences on the Rey Auditory Verbal Learning Test (RAVLT; total and delayed recall) raw scores and Brief Visuospatial Memory Test-Revised (BVMT-R) were demonstrated within the healthy but not the MCI or AD groups. Calculating z scores by sex for both dementing groups based on the healthy controls suggested a larger performance gap between healthy and dementing women than between healthy and dementing men. MCI females were on average 0.48 standard deviations lower for total verbal learning compared to healthy female controls than were MCI males when compared to healthy male controls. For verbal delayed recall the gap was even larger (SD = 1.09). Similarly, on the BVMT-R, a measure of visual memory, the difference was 0.60 standard deviations for total visual learning and 0.99 standard deviations for delayed recall. This same sex difference, with females showing greater impairment compared to the controls group than did the males, was also present within the AD group. The greater memory impairment in dementing females rather than males when compared to sex-matched healthy controls was unlikely to be due to more severe illness since females performed equivalently to males on the Clinical Dementia Rating Scale, Mini-Mental Status Examination, and Dementia Rating Scale, and were also similar for age, education, and apolipoprotein status. The present study suggested relatively greater memory impairment in females with MCI or AD than in controls.
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Affiliation(s)
- Shawn D Gale
- a Department of Psychology , Brigham Young University , Provo , UT , USA.,b Neuroscience Center , Brigham Young University , Provo , UT , USA
| | - Leslie Baxter
- c Department of Neuroimaging , Barrow Neurological Institute , Phoenix , AZ , USA
| | - Juliann Thompson
- a Department of Psychology , Brigham Young University , Provo , UT , USA
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Zhao L, Woody SK, Chhibber A. Estrogen receptor β in Alzheimer's disease: From mechanisms to therapeutics. Ageing Res Rev 2015; 24:178-90. [PMID: 26307455 DOI: 10.1016/j.arr.2015.08.001] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2015] [Revised: 08/04/2015] [Accepted: 08/17/2015] [Indexed: 12/21/2022]
Abstract
Alzheimer's disease (AD) disproportionally affects women and men. The female susceptibility for AD has been largely associated with the loss of ovarian sex hormones during menopause. This review examines the current understanding of the role of estrogen receptor β (ERβ) in the regulation of neurological health and its implication in the development and intervention of AD. Since its discovery in 1996, research conducted over the last 15-20 years has documented a great deal of evidence indicating that ERβ plays a pivotal role in a broad spectrum of brain activities from development to aging. ERβ genetic polymorphisms have been associated with cognitive impairment and increased risk for AD predominantly in women. The role of ERβ in the intervention of AD has been demonstrated by the alteration of AD pathology in response to treatment with ERβ-selective modulators in transgenic models that display pronounced plaque and tangle histopathological presentations as well as learning and memory deficits. Future studies that explore the potential interactions between ERβ signaling and the genetic isoforms of human apolipoprotein E (APOE) in brain aging and development of AD-risk phenotype are critically needed. The current trend of lost-in-translation in AD drug development that has primarily been based on early-onset familial AD (FAD) models underscores the urgent need for novel models that recapitulate the etiology of late-onset sporadic AD (SAD), the most common form of AD representing more than 95% of the current human AD population. Combining the use of FAD-related models that generally have excellent face validity with SAD-related models that hold more reliable construct validity would together increase the predictive validity of preclinical findings for successful translation into humans.
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Affiliation(s)
- Liqin Zhao
- Department of Pharmacology and Toxicology, School of Pharmacy, University of Kansas, Lawrence, KS 66045, USA; Neuroscience Graduate Program, University of Kansas, Lawrence, KS 66045, USA.
| | - Sarah K Woody
- Department of Pharmacology and Toxicology, School of Pharmacy, University of Kansas, Lawrence, KS 66045, USA
| | - Anindit Chhibber
- Department of Pharmacology and Toxicology, School of Pharmacy, University of Kansas, Lawrence, KS 66045, USA
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Pusswald G, Lehrner J, Hagmann M, Dal-Bianco P, Benke T, Marisa Loitfelder, Marksteiner J, Mosbacher J, Ransmayr G, Sanin G, Schmidt R. Gender-Specific Differences in Cognitive Profiles of Patients with Alzheimer’s Disease: Results of the Prospective Dementia Registry Austria (PRODEM-Austria). J Alzheimers Dis 2015; 46:631-7. [DOI: 10.3233/jad-150188] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- Gisela Pusswald
- Department of Neurology, Medical University of Vienna, Austria
| | - Johann Lehrner
- Department of Neurology, Medical University of Vienna, Austria
| | - Michael Hagmann
- Department of Medical Statistics and Informatics, Medical University of Vienna, Austria
| | | | - Thomas Benke
- Department of Neurology, Medical University of Innsbruck, Austria
| | - Marisa Loitfelder
- Department of Neurology, Division of Neurogeriatrics, Medical University of Graz, Austria
| | - Josef Marksteiner
- Department of Psychiatry and Psychotherapy, Regional Hospital Hall in Tirol, Austria
| | - Jochen Mosbacher
- Department of Neurology, Division of Neurogeriatrics, Medical University of Graz, Austria
| | | | - Guenter Sanin
- Department of Neurology, Medical University of Innsbruck, Austria
| | - Reinhold Schmidt
- Department of Neurology, Division of Neurogeriatrics, Medical University of Graz, Austria
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Miller LA, Flanagan E, Mothakunnel A, Mohamed A, Thayer Z. Old dogs with new tricks: Detecting accelerated long-term forgetting by extending traditional measures. Epilepsy Behav 2015; 45:205-11. [PMID: 25825369 DOI: 10.1016/j.yebeh.2015.01.024] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2014] [Revised: 01/19/2015] [Accepted: 01/21/2015] [Indexed: 11/30/2022]
Abstract
Accelerated long-term forgetting (ALF) is a condition in which normal memory performance is displayed after short delays, but significant memory loss is detected when memory is tested after several days or weeks. This condition has been reported in patients with epilepsy, but there are few normative scores available for its detection in clinical practice. In the present study, we assessed 60 healthy control subjects 18-60years of age on three memory measures [Rey Auditory Verbal Learning (RAVLT), Logical Memory (LM), and Aggie Figures] at delays of 30min and 7days. With these normative values, we determined cutoff scores to look for ALF and then categorized the performance of 15 patients with focal epilepsy on the same tasks. Seven of the patients showed ALF, and, in four of these, no other memory deficits (i.e., deficits at 30min on at least one task) were detected. Of the several demographic and epilepsy factors examined, only higher estimated IQ and older age predicted ALF (and only on one task: RAVLT). The findings provide a useful set of data to be applied in the clinic and some insight into the factors that influence retention within the first week.
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Affiliation(s)
- Laurie A Miller
- Institute of Clinical Neurosciences, Royal Prince Alfred Hospital, Camperdown, NSW, Australia; ARC-Centre of Excellence in Cognition and Its Disorders, University of Sydney, NSW, Australia.
| | - Emma Flanagan
- Neuroscience Research Australia, Sydney, NSW, Australia
| | - Annu Mothakunnel
- ARC-Centre of Excellence in Cognition and Its Disorders, Macquarie University, NSW, Australia
| | - Armin Mohamed
- Institute of Clinical Neurosciences, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
| | - Zoe Thayer
- Institute of Clinical Neurosciences, Royal Prince Alfred Hospital, Camperdown, NSW, Australia; ARC-Centre of Excellence in Cognition and Its Disorders, University of Sydney, NSW, Australia
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Caselli RJ, Dueck AC, Locke DE, Baxter LC, Woodruff BK, Geda YE. Sex-based memory advantages and cognitive aging: a challenge to the cognitive reserve construct? J Int Neuropsychol Soc 2015; 21:95-104. [PMID: 25665170 PMCID: PMC4785799 DOI: 10.1017/s1355617715000016] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Education and related proxies for cognitive reserve (CR) are confounded by associations with environmental factors that correlate with cerebrovascular disease possibly explaining discrepancies between studies examining their relationships to cognitive aging and dementia. In contrast, sex-related memory differences may be a better proxy. Since they arise developmentally, they are less likely to reflect environmental confounds. Women outperform men on verbal and men generally outperform women on visuospatial memory tasks. Furthermore, memory declines during the preclinical stage of AD, when it is clinically indistinguishable from normal aging. To determine whether CR mitigates age-related memory decline, we examined the effects of gender and APOE genotype on longitudinal memory performances. Memory decline was assessed in a cohort of healthy men and women enriched for APOE ɛ4 who completed two verbal [Rey Auditory Verbal Learning Test (AVLT), Buschke Selective Reminding Test (SRT)] and two visuospatial [Rey-Osterrieth Complex Figure Test (CFT), and Benton Visual Retention Test (VRT)] memory tests, as well as in a separate larger and older cohort [National Alzheimer's Coordinating Center (NACC)] who completed a verbal memory test (Logical Memory). Age-related memory decline was accelerated in APOE ɛ4 carriers on all verbal memory measures (AVLT, p=.03; SRT p<.001; logical memory p<.001) and on the VRT p=.006. Baseline sex associated differences were retained over time, but no sex differences in rate of decline were found for any measure in either cohort. Sex-based memory advantage does not mitigate age-related memory decline in either APOE ɛ4 carriers or non-carriers.
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Affiliation(s)
| | - Amylou C. Dueck
- Department of Biostatistics, Mayo Clinic Arizona, Scottsdale, Arizona
| | - Dona E.C. Locke
- Division of Psychology, Mayo Clinic Arizona, Scottsdale, Arizona
| | - Leslie C. Baxter
- Division of Psychology, Barrow Neurological Institute, Phoenix, Arizona
| | | | - Yonas E. Geda
- Department of Neurology, Mayo Clinic Arizona, Scottsdale, Arizona
- Department of Psychiatry, Mayo Clinic Arizona, Scottsdale, Arizona
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Chapman RM, Porsteinsson AP, Gardner MN, Mapstone M, McCrary JW, Sandoval TC, Guillily MD, Reilly LA, DeGrush E. The impact of AD drug treatments on event-related potentials as markers of disease conversion. Curr Alzheimer Res 2014; 10:732-41. [PMID: 23905997 DOI: 10.2174/15672050113109990148] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2012] [Accepted: 07/17/2013] [Indexed: 11/22/2022]
Abstract
This paper investigates how commonly prescribed pharmacologic treatments for Alzheimer's disease (AD) affect Event-Related Potential (ERP) biomarkers as tools for predicting AD conversion in individuals with Mild Cognitive Impairment (MCI). We gathered baseline ERP data from two MCI groups (those taking AD medications and those not) and later determined which subjects developed AD (Convert->AD) and which subjects remained cognitively stable (Stable). We utilized a previously developed and validated multivariate system of ERP components to measure medication effects among these four subgroups. Discriminant analysis produced classification scores for each individual as a measure of similarity to each clinical group (Convert->AD, Stable), and we found a large significant main Group effect but no main AD Medications effect and no Group by Medications interaction. This suggested AD medications have negligible influence on this set of ERP components as weighted markers of disease progression. These results provide practical information to those using ERP measures as a biomarker to identify and track AD in individuals in a clinical or research setting.
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Affiliation(s)
- Robert M Chapman
- Department of Brain and Cognitive Sciences, 775 Library Road, University of Rochester, Rochester, NY 14627, USA.
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Schmidt C, Becker H, Zerr I. Cerebrospinal fluid apolipoprotein E concentration and severity of cognitive impairment in patients with newly diagnosed Alzheimer's disease. Am J Alzheimers Dis Other Demen 2014; 29:54-60. [PMID: 24277910 PMCID: PMC11008136 DOI: 10.1177/1533317513505133] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND/OBJECTIVE Apolipoprotein E (apoE) plays an important role in the pathogenesis of Alzheimer's disease (AD). Altered cerebrospinal fluid (CSF) and plasma levels have been previously reported in patients with AD. We hypothesized that CSF apoE levels of patients with newly diagnosed AD might be associated with their cognitive performance. METHODS Patients with AD (N = 71) enrolled into an observational study underwent neuropsychological testing (Consortium to Establish a Registry for AD [CERAD] plus) at time of diagnosis. The CSF was obtained, and apoE concentrations were determined. Generalized linear models were constructed to assess the associations of apoE and neuropsychological measures while adjusting for important potential confounders. RESULTS No association of CSF apoE levels and cognitive function could be demonstrated. Still, the use of neuroleptic drugs, female gender, preprogression time, and lower education were linked to worse cognitive function in some domains. CONCLUSION The CSF apoE appears not to be suitable as a biochemical surrogate of cognitive function in AD under the given circumstances. By means of longitudinal analyses, potential associations with the velocity of decline will be investigated in the near future.
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Affiliation(s)
- Christian Schmidt
- Department of Neurology, Clinical Dementia Center, Georg-August-University, Goettingen, Germany
| | - Harry Becker
- Department of Neurology, Clinical Dementia Center, Georg-August-University, Goettingen, Germany
| | - Inga Zerr
- Department of Neurology, Clinical Dementia Center, Georg-August-University, Goettingen, Germany
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Intra-individual reaction time variability in mild cognitive impairment and Alzheimer's disease: gender, processing load and speed factors. PLoS One 2013; 8:e65712. [PMID: 23762413 PMCID: PMC3677873 DOI: 10.1371/journal.pone.0065712] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2012] [Accepted: 04/28/2013] [Indexed: 12/13/2022] Open
Abstract
Compared to cognitively healthy ageing (CH), intra-individual variability in reaction time (IIVRT), a behavioural marker of neurological integrity, is commonly reported to increase in both Alzheimer’s disease (AD) and mild cognitive impairment (MCI). It varies in MCI with respect to whether it represents the pro-dromal stages of dementia or not; being greatest in those most likely to convert. Abnormal IIVRT in MCI therefore represents a potential measure of underlying functional integrity that may serve to differentiate MCI from CH and to help identify those patients for whom MCI is the result of a progressive pathological process. As the clinical approach to MCI is increasingly stratified with respect to gender, we investigated whether this factor could influence study outcome. The influence of RTSPEED and processing load upon IIVRT was also examined. Under low processing load conditions, IIVRT was significantly increased in both MCI and AD compared to CH. However, correcting for an individual’s processing speed abolished this effect in MCI but not in AD, indicating that the increased IIVRT in MCI and AD may result from different factors. In MCI but not in CH, IIVRT was significantly greater for females. Increasing task processing load by adding distracting information, although increasing overall IIVRT, failed to improve the differentiation between CH and both MCI and AD, and in MCI resulted in a reduction in the influence of gender upon study outcome. The outcome of studies investigating IIVRT in MCI and AD compared to CH therefore appear influenced by the gender of the participants, by task-related processing load and processing speed.
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Schmidt C, Artjomova S, Hoeschel M, Zerr I. CSF prion protein concentration and cognition in patients with Alzheimer disease. Prion 2013; 7:229-34. [PMID: 23406922 DOI: 10.4161/pri.23904] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND/OBJECTIVE PrP (c) has been suggested to play a role in AD pathophysiology. CSF concentrations of PrP (c) have been shown to be reduced in AD compared with healthy controls. Furthermore, serum levels of PrP (c) have recently been reported to be associated with the cognitive status of healthy elderly subjects. Therefore, we hypothesized that CSF levels of PrP (c) could be associated with cognitive function of AD patients at the time of diagnosis. METHODS AD patients (n = 114) included into an observational study underwent CERAD testing and lumbar puncture at time of diagnosis / study inclusion. CSF PrP (c) was determined. Generalized linear models were fitted to assess the associations of PrP (c) plus a variety of possible confounding factors and CERAD subscale measures. RESULTS No association of CSF PrP (c) and cognitive status could be established, while other factors (i.e., use of antipsychotic drugs, use of anti-dementia drugs, female sex, pre-progression time) were related to worse cognitive function in some domains. CONCLUSION CSF PrP (c) appears not to be a useful biochemical surrogate of cognitive status in AD at the time of diagnosis. Follow-up analyses will examine possible associations with the speed of cognitive decline.
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Affiliation(s)
- Christian Schmidt
- Clinical Dementia Center, Department of Neurology, Georg-August-University, Goettingen, Germany.
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Irvine K, Laws KR, Gale TM, Kondel TK. Greater cognitive deterioration in women than men with Alzheimer's disease: a meta analysis. J Clin Exp Neuropsychol 2012; 34:989-98. [PMID: 22913619 DOI: 10.1080/13803395.2012.712676] [Citation(s) in RCA: 182] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Studies reporting on the cognitive abilities of men and women with Alzheimer's disease (AD) are surprisingly rare. We carried out a meta-analysis of neurocognitive data from 15 studies (n = 828 men; 1,238 women), which revealed a consistent male advantage on verbal and visuospatial tasks and tests of episodic and semantic memory. Moderator regression analyses showed that age, education level, and dementia severity did not significantly predict the male advantage. Reasons posited for this advantage include a reduction of estrogen in postmenopausal women, sex differences in AD pathology, and greater cognitive reserve in men.
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Affiliation(s)
- Karen Irvine
- Department of Psychology, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK.
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