Department of Psychiatry and Medical Psychology, Third Faculty of Medicine, Charles University, Prague, Czech Republic.
National Institute of Mental Health, Klecany, Czech Republic.
J Alzheimers Dis. 2022;88(1):345-355. doi: 10.3233/JAD-220040.
While the gender/sex differences in neuropsychiatric symptoms in dementia population are well described, gender/sex differences in mild behavioral impairment (MBI) in dementia-free populations and the relationship to cognitive performance and to subsequent cognitive decline have not been studied.
We aimed to explore gender/sex differences in the association of MBI with the level of cognitive performance and its rate of decline in a dementia-free cohort.
We studied 8,181 older adults enrolled in the online PROTECT UK Study. MBI was assessed using the MBI Checklist and cognition was measured by digit span, paired associate learning, spatial working memory, and verbal reasoning. Statistical analysis was conducted using linear regression models and linear mixed-effects models.
Out of 8,181 individuals (median age 63 years, 73% females), 11% of females and 14% of males had MBI syndrome. Females exhibited less often symptoms of decreased motivation (45% versus 36% in males), impulse dyscontrol (40% versus 44% in males; p = 0.001) and social inappropriateness (12% versus 15%; p < 0.001), while they showed more often symptoms of emotional dysregulation (45% versus 36%; p < 0.001). The associations of MBI domains with some measures of cognitive performance and decline were stronger in males than females, with the exception of the association of emotional dysregulation with the rate of cognitive decline in verbal reasoning, which was present exclusively in females.
MBI may influence cognition to a greater extent in males than in females. We propose that predictors and biomarkers of dementia should consider gender/sex as an effect modifier.
虽然痴呆人群中神经精神症状的性别/性别差异已有详细描述，但在无痴呆人群中，轻度行为障碍（MBI）的性别/性别差异以及与认知表现和随后认知能力下降的关系尚未得到研究。
我们旨在探讨无痴呆队列中 MBI 与认知表现水平及其下降速度的相关性中的性别/性别差异。
我们研究了参加在线 PROTECT UK 研究的 8181 名老年人。使用 MBI 检查表评估 MBI，使用数字跨度、成对联想学习、空间工作记忆和言语推理来衡量认知。使用线性回归模型和线性混合效应模型进行统计分析。
在 8181 名个体中（中位数年龄 63 岁，73%为女性），11%的女性和 14%的男性存在 MBI 综合征。女性表现出较少的动机减退症状（45%对男性的 36%）、冲动控制障碍（40%对男性的 44%；p=0.001）和社交不当（12%对男性的 15%；p<0.001），而她们表现出更多的情绪失调症状（45%对男性的 36%；p<0.001）。MBI 各领域与某些认知表现和下降指标的关联在男性中比女性中更强，情绪失调与言语推理认知下降率之间的关联除外，这种关联仅在女性中存在。
MBI 可能对男性的认知影响大于女性。我们提出，痴呆的预测因子和生物标志物应将性别/性别视为效应修饰剂。
