School of Life and Medical Sciences, University of Hertfordshire.
Hertfordshire Partnership University NHS Foundation Trust, Hatfield, Hertfordshire, UK.
Curr Opin Psychiatry. 2018 Mar;31(2):133-139. doi: 10.1097/YCO.0000000000000401.
Women are more impacted by Alzheimer's disease than men - they are at significantly greater risk of developing Alzheimer's disease, and recent research shows that they also appear to suffer a greater cognitive deterioration than men at the same disease stage. The purpose of this article is to review recent studies on examining sex differences in cognitive function in Alzheimer's disease.
We searched electronically for articles, reviews and meta-analyses published between 1/2016 and 12/2017 and identified 298 articles on sex differences in cognition in Alzheimer's disease. The key themes to emerge were sex differences in cognitive function, risk factors, resilience, and cognitive reserve.
Evidence is steadily and increasingly accumulating to confirm the poorer cognitive outcome for women than men with Alzheimer's disease. Although small in size, the effects occur across a broad range of cognitive domains including visuospatial, verbal, episodic memory, and semantic memory - some of which typically reveal a sex-related processing advantage for healthy women. Explanations have been linked to a variety of factors including differences in cognitive reserve, resilience, as well as genetics (apolipoprotein ε4) and functional and structural brain changes. Sex-related differences in risk factors, resilience, cognitive reserve, and rates of deterioration have implications for clinical practice.
目的综述：女性受阿尔茨海默病的影响大于男性——她们患阿尔茨海默病的风险明显更高，最近的研究还表明，在相同疾病阶段，女性的认知能力下降也比男性更为严重。本文旨在综述最近关于阿尔茨海默病认知功能性别差异的研究。
最新发现：我们检索了 2016 年 1 月至 2017 年 12 月期间发表的关于阿尔茨海默病认知性别差异的文章、综述和荟萃分析，共找到 298 篇文章。出现的关键主题包括认知功能、风险因素、韧性和认知储备方面的性别差异。
总结：越来越多的证据证实，女性在认知方面的结局比男性阿尔茨海默病患者更差。尽管规模较小，但这些影响发生在广泛的认知领域，包括视空间、语言、情景记忆和语义记忆，其中一些在健康女性中通常表现出与性别相关的处理优势。解释与多种因素有关，包括认知储备、韧性以及遗传因素（载脂蛋白 E4）和功能及结构脑变化的差异。与性别相关的风险因素、韧性、认知储备和恶化率的差异对临床实践具有重要意义。
