The Florey Institute, The University of Melbourne, Victoria, Australia; Melbourne School of Psychological Science, University of Melbourne, Victoria, Australia; Harvard Aging Brain Study, Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA; Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Women's Hospital, Boston, MA, USA.
Department of Neurology, Stanford University, CA, USA.
Alzheimers Dement. 2018 Sep;14(9):1193-1203. doi: 10.1016/j.jalz.2018.04.010. Epub 2018 May 24.
Our objective was to investigate the effect of sex on cognitive decline within the context of amyloid β (Aβ) burden and apolipoprotein E genotype.
We analyzed sex-specific effects on Aβ-positron emission tomography, apolipoprotein, and rates of change on the Preclinical Alzheimer Cognitive Composite-5 across three cohorts, such as the Alzheimer's Disease Neuroimaging Initiative, Australian Imaging, Biomarker and Lifestyle, and Harvard Aging Brain Study (n = 755; clinical dementia rating = 0; age (standard deviation) = 73.6 (6.5); female = 55%). Mixed-effects models of cognitive change by sex, Aβ-positron emission tomography, and apolipoprotein ε4 were examined with quadratic time effects over a median of 4 years of follow-up.
Apolipoprotein ε4 prevalence and Aβ burden did not differ by sex. Sex did not directly influence cognitive decline. Females with higher Aβ exhibited faster decline than males. Post hoc contrasts suggested that females who were Aβ and apolipoprotein ε4 positive declined faster than their male counterparts.
Although Aβ did not differ by sex, cognitive decline was greater in females with higher Aβ. Our findings suggest that sex may play a modifying role on risk of Alzheimer's disease-related cognitive decline.
我们的目的是在淀粉样蛋白β（Aβ）负担和载脂蛋白 E 基因型的背景下，研究性别对认知能力下降的影响。
我们分析了三个队列（阿尔茨海默病神经影像学倡议、澳大利亚成像、生物标志物和生活方式以及哈佛衰老大脑研究）中，性别对 Aβ 正电子发射断层扫描、载脂蛋白和临床前阿尔茨海默病认知综合量表-5 变化率的具体影响，共有 755 名参与者（临床痴呆评定量表=0；年龄（标准差）=73.6（6.5）；女性=55%）。通过混合效应模型，对认知变化按性别、Aβ 正电子发射断层扫描和载脂蛋白 ε4 进行了检查，在中位数为 4 年的随访期间，使用二次时间效应。
载脂蛋白 ε4 的患病率和 Aβ 负担与性别无关。性别并没有直接影响认知能力下降。Aβ 水平较高的女性认知下降速度比男性更快。事后对比表明，Aβ 和载脂蛋白 ε4 阳性的女性比男性下降速度更快。
尽管 Aβ 没有性别差异，但 Aβ 水平较高的女性认知能力下降更为明显。我们的研究结果表明，性别可能在阿尔茨海默病相关认知能力下降的风险中起调节作用。
