Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland, USA.
Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, USA.
Int J Geriatr Psychiatry. 2019 Jul;34(7):1008-1017. doi: 10.1002/gps.5102. Epub 2019 Apr 25.
The reasons why women are at higher risk than men for developing dementia are unclear. Although studies implicate sex differences in the effect of stress on cognitive functioning, whether stressful life events are associated with subsequent cognitive decline has received scant research attention.
In Wave 3 (1993-1996) of the Baltimore Epidemiologic Catchment Area study, 337 men and 572 women (mean age = 47 years) reported recent (within the last year) and remote (from 1981 until 1 year ago) traumatic events (eg, combat) and stressful life events (eg, divorce/separation). At Waves 3 and 4 (2004-2005), they completed the Mini Mental State Examination (MMSE) and a word-list memory test. Multivariable models were used to examine the association between traumatic and stressful life events at Wave 3 and cognitive change by Wave 4.
A greater number of recent stressful life events at Wave 3, but not of more remote stressful events, was associated with greater verbal memory decline by Wave 4 in women but not in men. Stressful events were not associated with change in MMSE, and there were no associations between traumatic events occurring at any time and subsequent memory or MMSE decline in either sex.
Unlike men, middle-aged women with a greater number of recent stressful life events demonstrate memory decline over a decade later. Sex differences in cognitive vulnerability to stressful life events may underlie women's increased risk of memory impairment in late life, suggesting that stress reduction interventions may help prevent cognitive decline in women.
女性比男性更容易患上痴呆症，其原因尚不清楚。虽然研究表明压力对认知功能的影响存在性别差异，但压力性生活事件是否与随后的认知能力下降有关，这方面的研究关注甚少。
在巴尔的摩流行病学抽样区研究的第 3 波（1993-1996 年）中，337 名男性和 572 名女性（平均年龄 47 岁）报告了最近（过去 1 年内）和遥远的（1981 年至今 1 年前）创伤事件（如战斗）和压力性生活事件（如离婚/分居）。在第 3 波和第 4 波（2004-2005 年），他们完成了简易精神状态检查（MMSE）和单词记忆测试。多变量模型用于检验第 3 波时的创伤和压力性生活事件与第 4 波时的认知变化之间的关系。
第 3 波时近期压力性生活事件的数量较多，而不是较遥远的压力性生活事件较多，与女性的言语记忆衰退有关，但与男性无关。压力性生活事件与 MMSE 的变化无关，而且在任何时候发生的创伤性事件与随后的记忆或 MMSE 衰退在两性中均无关联。
与男性不同，近期经历更多压力性生活事件的中年女性在 10 多年后会出现记忆衰退。认知对压力性生活事件的性别差异可能是女性晚年记忆力下降风险增加的原因，这表明减轻压力的干预措施可能有助于预防女性的认知能力下降。
