Gender differences in predictors of mental health among older adults in South Korea

Reading Holy Quran Associated With Better Cognitive Function in Older Adults: A Systematic Review

Background: As the global population ages, understanding factors that contribute to better cognitive function in older adults becomes crucial. This systematic review delves into the potential relationship between reading the Holy Quran and cognitive function in older adults. Methods: A systematic search was conducted across five electronic databases (PubMed, ScienceDirect, Google Scholar, Tripdatabase, Cochrane) to identify relevant studies that were published between 2004 to December 2023. Inclusion criteria were centered on studies exploring the correlation between reading the Quran and cognitive function in older adults. Results: Five studies meeting the inclusion criteria were included in this systematic review. Notably, four of these studies reported a significant correlation between the intensity or duration of Quranic reading and improved cognitive function in older adults. Discussion: The findings imply a potential positive association between engaging with the Holy Quran and cognitive function among the elderly. This relationship holds promise for potential applications in cognitive health interventions for older adults especially for Muslim patients. Conclusion: This review provides evidence supporting the relationship between reading the Holy Quran and normal cognitive function in older adults. The consistent findings underscore the importance of further research to elucidate underlying mechanisms and consider potential implications for cognitive health interventions.

The Reciprocal Relationship of Physical Capacity and Mental Health: A Random Intercept Cross-Lagged Panel Model Analysis

This study investigates the mutual influence of mental health and physical capacity in older adults, considering potential gender differences. Data from 7,504 Medicare beneficiaries aged 65+ from the NHATS 2011-2015 surveys were analyzed using a random intercept cross-lagged panel model in Mplus. Results revealed moderate within-person effects of physical capacity on mental health (βt12 = -.19, βt23 = -.32, βt34 = -.42, βt45 = -.40), while the reverse relationship showed smaller effects (βt12 = -.02, βt23 = -.03, βt34 = -.03, βt45 = -.02). Gender differences emerged, with the influence of mental health on physical capacity being significant in men but not women. Additionally, correlations between changes in physical capacity and mental health were stronger for men. Lastly, lagged effects of physical capacity on mental health were notably stronger than the reverse. The findings suggest that enhancing physical capacity may alleviate depression and anxiety symptoms in older adults, particularly men.

Sex differences on anxiety and depression in older adults and their relationship with cognitive impairment

INTRODUCTION

Subjective memory complaints (SMCs) in elderly adults could express cognitive decline in the future. A consensus has been reached about how these SMC relate to mood variables, but further research is required to determine which socio-demographic, cognitive, functional and occupational factors will act as predictors in elderly adults.

OBJETIVE

To analyze, through a descriptive observational study, the relationship between anxiety/depression and sex, age and occupation, with cognitive/functional performance in 367 older adults with SMC, but without objective cognitive impairment in a primary healthcare center.

METHODS

The cognitive variables were measured by applying the Spanish version of Mini-Mental State Examination (MEC-35) and Set-test for verbal fluency. To measure functional level, the Barthel index and Lawton and Brody scales were employed. Physical occupational status and mental occupational status were measured based on three levels, low, medium and high, according to the American Occupational Therapy Association.

RESULTS

Low educational and occupational physical and mental levels were related to anxiety and depression. In addition, differences by sex were found on anxiety and depression related to different factors. In men, anxiety was related to higher cognitive level, and in women to higher functional performance in IADLs. On the contrary, depression in men was related to lower cognitive level and higher performance in ADLs.

CONCLUSIONS

It is important to maintain a sex-gender perspective on the study of anxiety and depression in elderly, taking into account social roles and the traints of the work environment, in order to avoid cognitive and functional impairment.

Mental health status and its associated factors among female nurses in the normalization of COVID-19 epidemic prevention and control in China

Objective

To investigate mental health status and its associated factors among female nurses in the normalization of COVID-19 epidemic prevention and control in China.

Methods

Random cluster sampling was applied to recruit 740 female nurses in China. The respondents completed the survey with mobile devices. Demographic questionnaire, Generalized Anxiety Disorder-7, Patient Health Questionnaire-9, Insomnia Severity Index, and The Impact of Event Scale-Revised were used to assess demographic Information, anxiety, depression, insomnia and PTSD symptoms, respectively. The associated factors of mental health status were identified by binary logistic regression analysis.

Results

The prevalence of anxiety and depression was 7.9 and 17.8%, respectively. Insomnia was an associated factor of anxiety (OR = 6.237, 95%CI = 6.055-23.761, P < 0.001) and depression (OR = 9.651, 95%CI = 5.699-22.370, P < 0.001), while PTSD was an associated factor of anxiety (OR = 11.995, 95%CI = 2.946-13.205, P < 0.001) and depression (OR = 11.291, 95%CI = 6.056-15.380, P < 0.001), Being married was a protective factor of depression (OR = 0.811, 95%CI = 1.309-6.039, P < 0.01).

Conclusion

Female nurses showed problems in mental health. Insomnia, PTSD and marital status were associated with mental health. The hospital management should pay more attention to the unmarried groups, and strive to improve the sleep quality of female nurses and reduce their stress caused by traumatic events.

Predicting the gender difference in depressive symptoms in older adults

Objectives: The gender difference in depressive symptoms in older adults is well-established, with women exhibiting approximately twice as many depressive symptoms as men across the life span. However, almost no studies have explored why we see this pattern in older adults.Method: In this study, moderation, mediation and reverse mediation analyses were used to learn how gender differences in psychosocial and health variables contribute to the gender difference in depressive symptoms in 60-74 year old participants in the baseline sample of the ORANJ BOWL study (n = 3008).Results: Moderation analyses show that functional ability, health, social support, and living alone interact with gender to predict depressive symptoms. Mediation analyses demonstrate that gender differences in financial comfort, social support, health, functional ability and living alone help explain the gender difference in depression. Reverse mediation analyses show that depressive symptoms also predict the gender difference in psychosocial and health variables.Conclusion: While the moderation analyses show multiple points of entry for clinical implications, they do not provide clarity that explains the gender difference in depressive symptoms. Mediation analyses highlight the roles of functional ability, financial comfort, health and living alone in explaining the gender difference. Reverse mediation analyses suggest a negative feedback loop between depressive symptoms and the predictor variables, with gender differences in functional ability, financial comfort, health and living alone at least partially explained by gender differences in depression. The findings highlight opportunities for targeted depression screening and to identify the gender inequities that need attention in order to reduce disadvantages for women.

Depressive symptoms among cancer patients: Variation by gender, cancer type, and social engagement

Prior literature has documented an association between cancer and depressive symptoms. There has been a limited understanding about whether the association between cancer and depressive symptoms varies by gender and whether social engagement moderates this association. Using seven waves of the Korean Longitudinal Study of Ageing (N = 10,055), we examine the association between cancer and depressive symptoms among middle- and older-aged adults in Korea. We conduct fixed-effects regression models to account for unobserved characteristics of individuals that may confound this association. We first investigate whether the association between cancer and depressive symptom differs by gender. We distinguish among cancer types to assess potentially distinctive mental health consequences of different types of cancer. Then, we explore whether social engagement moderates the cancer-depressive symptoms association. Naive OLS models yielded significant associations between cancer and depressive symptoms for both men and women. However, our preferred fixed effects estimates revealed that the association was statistically significant only for men, and not for women. This association was especially pronounced for lung cancer. We also found that one's level of social engagement including informal connections and formal social activities moderates the link between cancer and depressive symptoms. Cancer is not only a leading cause of death, but also a serious threat to one's mental health. This study sheds light on gender differences in psychological reactions to cancer among Korean adults. Findings of this study hold important implications for programs aiming to improve the mental health and quality of life of cancer patients.

The Magnifying Effect of Marital Satisfaction on the Dyadic Effect of Disabilities on Life Satisfaction

(1) Background. Extending previous work, the present study examined whether marital satisfaction would magnify the dyadic effect of disabilities on life satisfaction among older married couples. (2) Methods. With responses collected from 11,694 participants (5847 couples; Mage = 63.36 years, median: 62 years) in a large-scale survey study in China in 2015, the actor-partner interdependence model (APIM) analyses were conducted to examine how marital satisfaction moderated the actor and partner effects of disabilities on life satisfaction. In addition, mixed linear model analyses were conducted to examine the gender effect. (3) Results. The results showed that marital satisfaction magnified the negative association between disabilities and life satisfaction with different patterns for each gender. Specifically, husbands’ disabilities significantly negatively predicted their own levels of life satisfaction among those with higher marital satisfaction but not among those with lower marital satisfaction. In contrast, for wives, spousal disabilities significantly predicted lower levels of life satisfaction among those with higher marital satisfaction but not among those with lower marital satisfaction. (4) Conclusions. The evidence for the magnifying effect of marital satisfaction obtained in the present study implicates the importance of taking dyadic dynamics in close relationships into account in health care research.

Productive Activities and Risk of Cognitive Impairment and Depression: Does the Association Vary by Gender?

We examine how labor together with social participation protects against cognitive impairment and depression, with a focus on gender differences. Data are drawn from four waves of the Korean Longitudinal Study of Aging (2006-2012). Both paid work and unpaid work are considered labor participation. Social participation includes the frequency of participation in formal social institutions, religious groups, grandparenting, and interactions with family and friends. Using growth curve models, we find that social and labor participation are independently associated with outcomes and effects vary by gender. Religious group activity was beneficial only for women, whereas inability to work was detrimental for men only. Informal social gatherings and labor participation, paid or unpaid, were beneficial for both genders. Findings on gender differences highlight how social identities can shape social roles and confine activity space, and productive engagement, affecting outcomes for mental health in later life.

Posttraumatic Stress and Depression Among Syrian Refugees Living in Turkey: Findings From an Urban Sample

Although most of the 3.6 million Syrian refugees in Turkey live outside refugee camps, most mental health research is on camp residents and few are on those living in cities. We aimed to assess the prevalence and predictors of posttraumatic stress disorder (PTSD) and depression in Syrian refugees living in an urban area in Turkey. A total of 420 adult Syrians living in Ankara were assessed using the Harvard Trauma Questionnaire and the Beck Depression Inventory. Probable PTSD and depression rates were 36.5% and 47.7%, respectively. Female sex, physical illness, and greater number of potentially traumatic events predicted both PTSD and depression. PTSD was additionally predicted by past psychiatric illness, and depression was predicted by lower economic status. Interestingly, lower economic status predicted depression among men, but not among women. Studies on refugees should be sensitive to factors that could have a significant effect on mental health such as sex or residence.

Effect of sociodemographic and physical activity on cognitive function in older adults: A nationwide cross-sectional survey

OBJECTIVE

We aimed to assess the effect of socioeconomic status and physical activity on cognitive function using a large population-based survey data in China.

METHODS

We took advantage of the Chinese Longitudinal Healthy Longevity Survey conducted in 2014 to examine the relationship between sociodemographic, physical activity, and cognitive function in older adults (OAs) for persons aged above 65 (N = 2848). Socioeconomic status was assessed by sex, age, co-residence situation, category of residence, years of schooling, and marital status. Multiple linear regression for predictors was utilized. Physical activity was assessed using activities of daily living (ADL) and instrumental activities of daily living (IADL) measures. Cognitive function was assessed by the Modified Mini-Mental State Examination.

RESULTS

The mean age of the OAs was 80.65 years (SD = 8.55). Their mean Mini-Mental State Examination score was 21.55 (SD = 2.38), mean ADL Total score was 6.24 (SD = 0.95), and mean IADL Total score was 10.21 (SD = 3.84). OAs' age at testing, co-residence and category of residence significantly predicted both ADL Total score and IADL Total score (P < 0.05), sex significantly predicted IADL Total score (R²  = 0.02, β = 0.13, P = 0.000) but not ADL Total score (R²  = 0.00, β = 0.02, P = 0.211). OAs' sex, age, co-residence, and years of schooling significantly predicted cognitive function (P < 0.05), IADL total score significantly predicted cognitive function (P < 0.01), while the relationship between ADL total score and cognitive function was not significant (P = 0.94).

CONCLUSION

OAs' sex, age, co-residence, years of schooling, and IADL were significantly associated with cognitive function. Improving OAs' IADL, especially in lower social classes, may help to improve the overall cognitive function of the OAs.

The impact of perceived social support, loneliness, and physical activity on quality of life in South Korean older adults

PURPOSE

The purpose of this study was to propose and test a conceptual model that explains the interrelationships among perceived social support, loneliness, physical activity (PA), and quality of life (QoL) among active older adults in South Korea.

METHODS

Data were collected from 332 individuals over the age of 65 using a systematic stratified convenience sampling method. Survey data were collected and analyzed using a structural equation model (SEM).

RESULTS

Perceived social support had a significantly positive effect on PA (β = 0.14, p < 0.01) and QoL (β = 0.28, p < 0.001) while decreasing loneliness (β = -0.55, p < 0.001). PA had a significant positive effect on QoL (β = 0.12, p < 0.01), and loneliness had a negative effect on QoL (β = -0.37, p < 0.001). Loneliness mediated the relationship between perceived social support and QoL.

CONCLUSION

The SEM results of the current study support the proposed model that explained the interrelationships among perceived social support, loneliness, PA, and QoL among active older adults in South Korea. These findings suggest the importance of incorporating social support mechanisms for PA interventions in order to enhance QoL. The findings of this study can help create more effective health and physical education programs for the older generations in South Korea to enhance their QoL.

The Gender Difference in Depression: Are Elderly Women at Greater Risk for Depression Than Elderly Men?

Numerous epidemiological reports have found that adolescent, young adult, and middle-aged adult girls and women are more likely to be diagnosed with unipolar depression and report greater symptoms of depression when compared to boys and men of similar ages. What is less well-known is whether this gender difference persists into late life. This literature review examines whether the well-known gender difference in unipolar depression continues into old age, and, if it does, whether the variables that are known to contribute to the gender difference in unipolar depression from adolescence through adulthood continue to contribute to the gender difference in the elderly, and/or whether there are new variables that arise in old age and contribute to the gender difference in the elderly. In this review of 85 empirical studies from every continent except for Antarctica, we find substantial support for the gender difference in depression in individuals who are 60 and older. More research is necessary to determine which factors are the strongest predictors of the gender difference in depression in late life, and particularly whether the factors that seem to be responsible for the gender difference in depression in earlier life stages continue to predict the gender difference in the elderly, and/or whether new factors come into play in late life. Longitudinal research, meta-analyses, and model-based investigations of predictors of the gender difference in depression are needed to provide insights into how and why the gender difference in depression persists in older age.

Community Social Capital, Built Environment, and Income-Based Inequality in Depressive Symptoms Among Older People in Japan: An Ecological Study From the JAGES Project

Background

Although reducing socioeconomic inequalities in depression is necessary, their associated factors have rarely been studied. This study aimed to screen the potential contextual factors associated with income-based inequality in older adults’ depression.

Methods

Using data from the Japan Gerontological Evaluation Study (JAGES) of 2013, we conducted an ecological study covering 77 communities in Japan. Our measures of socioeconomic inequalities in depression were the slope index of inequalities (SII) and the relative index of inequalities (RII) of the prevalence of depressive symptoms across three income levels. We categorized available community-level factors, including socio-demographic factors, social participation, social relationships, subjective changes in the residential area, and the built environment. These indicators were aggregated from individual responses of 51,962 and 52,958 physically independent men and women, respectively, aged 65 years or more. We performed multiple linear regression analyses to explore factors with statistical significance of a two-tailed P-value less than 0.05.

Results

Factors associated with shallower gradients in depression for men included higher participation in local activities and reception or provision of social support, which did not show significant association among women. Perceived increases in unemployment and economic inequalities were positively associated with larger inequalities in both genders (P < 0.05). The built environment did not indicate any significant association.

Conclusions

A community environment fostering social activities and relationships might be associated with smaller income-based inequalities in depression. There is a need for more deterministic studies for planning of effective community interventions to address socioeconomic inequalities in depression.

Risk factors for cognitive decline associated with gait speed in community-dwelling elderly Koreans with MMSE scores of 30

BACKGROUND AND AIM

We aimed to investigate the association between lower gait speed and cognitive decline over a 3-year period in community-dwelling older people with mini-mental state examination (MMSE) scores of 30 at baseline.

METHODS

The study was based on data from 10,003 Koreans aged 60 years or older who completed the National Elderly Survey in both 2008 and 2011. Among them 620 subjects achieved MMSE scores of 30 in 2008. Over a 3-year period, preservation of MMSE score 28 or more was defined as preserved cognition and decrease of three or more points as cognitive decline. A 4-m gait speed was measured at baseline. Data on sociodemographic factors (age, number of schooling years, and household composition), alcohol drinking, current smokers, Korean version of Short form Geriatric Depression Scale score, and self-reported comorbid conditions, were collected.

RESULTS

Of 620 (weighted 884) respondents included in the analysis, 208 (52.3 %) of 398 males (weighted 567) and 152 (68.5 %) of 222 females (weighted 317) suffered cognitive decline over the 3-year period. After adjustment, lower gait speed was associated with cognitive decline in males (OR 2.29; 95 % CI 1.07-4.89, P = 0.032). Educational level was a significant risk factor for both men and women (OR 0.86; 95 % CI 0.79-0.93 in males, OR 0.75; 95 % CI 0.65-0.87 in females). Males diagnosed with hypertension (OR 0.44; 95 % CI 0.22-0.88) or male smokers (OR 0.38; 95 % CI 0.19-0.75) were significantly less likely to have cognitive decline. There was no significant association between cognitive decline and gait speed in females.

CONCLUSIONS

Higher 4-m gait speed is associated with preservation of cognitive function over time in men, but not in women.

Relationship Between Ties With Adult Children and Life Satisfaction Among the Middle-Aged, the Young-Old, and the Oldest-Old Korean Adults

One of the important determinants of well-being among aging parents is their relationship with adult children. Using the two waves of the Korean Longitudinal Study of Ageing, this study examined how different types of ties with adult children affect the life satisfaction of the Korean middle-aged, the young-old, and the oldest-old adults. Multigroup analysis was used to see if the effects of ties with adult children differ by the three age-groups. The results showed that frequency of contact had positive effect on life satisfaction for all of the age-groups. However, coresidence with children had a negative effect for the middle-aged, but a positive effect for the oldest-old. Finally, exchanges of support with adult children had significant effects only for the young-old. These results show that the importance of different types of ties with children change according to aging parents' life stages.

Living arrangements and suicidal ideation among the Korean older adults

OBJECTIVES

This study examines how living arrangements are associated with suicidal ideation for older adults in South Korea, which has the highest suicide rate among OECD countries, and a particularly high suicide rate for older persons.

METHODS

Analyzing a sample of 5795 women and 3758 men aged 65 and older from a nationwide representative cross-sectional data-set, we examined how many older adults think about suicide over a one-year period, why they think about suicide, and whether living arrangements are associated with suicidal ideation.

RESULTS

About 1 out of 12 respondents in our sample reported suicidal ideation. While women and men did not differ in the prevalence of suicidal ideation, women attributed their suicidal feelings to health problems, while men attributed theirs to economic difficulties. Logistic regression results indicated that living arrangements are associated with suicidal ideation for men but not women. Older men living with a spouse were less likely to have suicidal ideation than older men with other living arrangements (i.e., living alone, living with children without spouse, living with spouse, and others).

CONCLUSIONS

Our results highlight the importance of living arrangements to older men's suicidal ideation. We discuss gender differences in the implications of living arrangements to suicidal ideation within the context of Confucian culture.

Urban and rural factors associated with life satisfaction among older Chinese adults

OBJECTIVE

This study compared urban and rural factors associated with life satisfaction among older adults in mainland China.

METHOD

Study data were extracted at random from 10% of the Sample Survey on Aged Population in urban/rural China in 2006 for 1980 participants aged 60 and older, including 997 from urban cities and 983 from rural villages.

RESULTS

In this study, 54.6% of urban older adults and 44.1% of rural older adults reported satisfaction with their lives. Binary logistic regression analysis showed that financial strain, depressive symptoms, filial piety, and accessibility of health services were significantly associated with life satisfaction for both urban and rural participants, but age and financial exchange with children were only associated with life satisfaction among urban older adults.

CONCLUSION

Findings are consistent with some previous studies that indicated the importance of financial strain, depressive symptoms, filial piety, and accessibility of health services to life satisfaction among the older adults in both urban and rural areas. This study also demonstrated the importance of age and family financial exchange to the life satisfaction of urban older adults.

Perceived Risk of Mental Health Problems in Primary Care

In the face of limited resources and an aging population with increasingly care needs, healthcare systems must identify community-dwelling older adults with mental health problems at higher risk of adverse outcomes such as institutionalization, hospitalization and death, in order to deliver timely and efficient care. The objectives of this study were to assess the prevalence of mental health concerns and the associated perceived risk of adverse outcomes in a large sample of older patients in primary care (PC). We trained general practitioners and nurses to use the Risk Instrument for Screening in the Community to rank perceived risk of mental health concerns (including neurocognitive and mood disorders) from 1 (mild) to 3 (severe). The mean age of the 4499 people assessed was 76.3 years (SD = 7.3) and 2645 (58.8%) were female. According to the PC team 1616 (35.9%) were perceived to have mental health concerns of whom 847 (52.4%) were mild, 559 (34.6%) were moderate and 210 (13%) were severe. Patients with mental health concerns had higher odds of perceived risk of adverse outcomes (OR = 2.22, 95% CI 1.83–2.69 for institutionalization; OR = 1.66, 95% CI 1.41–1.94 for hospitalization; OR = 1.69, 95% CI 1.42–2.01 for death). These results suggest a high prevalence of mental health concerns among older adults and supports the need for early identification of patients at high-risk of adverse healthcare outcomes.

The Role of Leisure Engagement for Health Benefits Among Korean Older Women

This qualitative study was designed to examine the benefits of leisure to older Korean women. Using a constructive grounded theory methodology, in this study we identified three categories of benefits from leisure activities: (a) developing social connections, (b) enhancing psychological well-being, and (c) improving physical health. The findings of this study demonstrate that involvement in leisure activities offers substantial physical, psychological, and social benefits for older Korean women. The results also suggest that these benefits can provide an opportunity for older Korean adults to improve their health and well-being, which, in turn, may help promote successful aging.

Depressive Symptoms of Older Adults Living Alone: The Role of Community Characteristics

Although some evidence suggests that community characteristics may play an important role in the development of depressive symptoms among older adults, current literature has not attended to the role of community characteristics in depression in South Korea. This study begins to address this gap in the literature by examining the relationship of community characteristics and depressive symptoms, controlling for individual characteristics. Using a cross-sectional design and probability sampling, we surveyed 949 older adults living alone in 70 communities in the Busan metropolitan area in South Korea in 2012. A multilevel logistic regression analysis was conducted to test the hypothesis that community characteristics are predictive of depressive symptoms. We find that both the proportion of older adults and the number of senior citizen facilities in a community are associated with depressive symptoms, whereas community poverty is not related to depressive symptoms. Men with lower income, with lower levels of functional abilities, and without stronger family and friend social networks have a higher risk of depressive symptoms. Implications for research, practice, and policy are discussed.

Intergenerational financial exchange and the psychological well-being of older adults in the Republic of Korea

OBJECTIVES

This study examined whether the exchange of instrumental support (i.e., financial resources) among older adults and their children was related to the psychological well-being of older Koreans.

METHODS

Data from the Korean Longitudinal Study of Ageing were employed. Older adults who were aged 65 and older and who had at least one living child who did not live in the respondent's household were included (N = 3791). Well-being was measured with depressive symptoms (CES-D-10) and life satisfaction. For the direction model of exchange, giving and receiving support was assessed with financial aid (cash and non-cash). For the reciprocity model of exchange, four patterns of financial exchanges were identified: both giving and receiving, receiving only, giving only, and no exchange.

RESULTS

The results from the direction model showed that older adults who give financial support were less likely to be depressed and reported higher levels of life satisfaction. The effect of receiving support was not significant for depression but was related to higher levels of life satisfaction. The results from the reciprocity model showed that those who gave and received support had better psychological health compared to those who only received support.

CONCLUSIONS

Both giving and receiving were positively related to the psychological well-being of older adults. Our results provide support for identity theory and equity theory as frameworks for understanding intergenerational exchange and well-being of older Koreans.

Alcohol consumption and cognitive impairment among Korean older adults: does gender matter?

BACKGROUND

This study investigated gender differences in the relationship between alcohol consumption and cognitive impairment among older adults in South Korea.

METHODS

Using data from the Korean Longitudinal Study of Ageing, 2,471 females and 1,657 males were analyzed separately. Cognitive impairment was measured based on the Korean version of the Mini-Mental State Exam score. Logistic regression was conducted to examine the relationship between alcohol consumption and cognitive impairment among Korean older adults.

RESULTS

Multivariate analysis showed that compared to moderate drinkers, past drinkers were more likely to be cognitively impaired for women, while heavy drinkers were more likely to be cognitively impaired for men.

CONCLUSIONS

Findings suggest that the relationship between alcohol consumption and cognition varies with gender. Clinicians and service providers should consider gender differences when developing strategies for the prevention and treatment of alcohol-related cognitive decline among older adults.