Department of Preventive Medicine and Public Health (EL), Universidad de Zaragoza, Zaragoza, Spain; Instituto de Investigación Sanitaria de Aragón (IIS Aragón) (EL, AL, RLA, PS, PGG, CDC) Zaragoza, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM) (EL PGG, RLA, CDC), Ministry of Science and Innovation, Madrid, Spain.
Instituto de Investigación Sanitaria de Aragón (IIS Aragón) (EL, AL, RLA, PS, PGG, CDC) Zaragoza, Spain; Department of Medicine and Psychiatry (AL, PGG, PS, CDC), Universidad de Zaragoza, Zaragoza, Spain.
Am J Geriatr Psychiatry. 2023 Oct;31(10):796-807. doi: 10.1016/j.jagp.2023.04.012. Epub 2023 Apr 29.
The objective of this study was to document the longitudinal trajectories of cognitive aging in a sample of cognitively healthy subjects of 55 years or older. The following differences between men and women were hypothesized: 1) in the cognitive loss through aging, 2) in the distinct trajectories identified; and 3) in the predictors associated with the identified trajectories.
A 4-wave, population-based study in Zaragoza, Spain (1994-2006).
A total of 2,403 individuals aged 55+ years, cognitively healthy at baseline.
All participants had at least three measurements with the Mini-Mental State Examination (MMSE). Validated Spanish versions of international instruments were used for assessment. Random effects linear panel regression model for analyzing differences by sex in MMSE scores through aging were performed, and growth mixture models (GMM) applied independently for each sex for modeling the longitudinal cognitive trajectories.
Women showed lower mean MMSE scores in all phases and significantly higher loss in the MMSE from phases 2 to 3 and 3 to 4. The best fitting age-adjusted model of the cognitive trajectories was a 4-class GMM in men and a 3-class in women. Education was a predictor of cognitive trajectories in both men and women. Dependence on iADLs and alcohol status were predictors only for men, and depression and diabetes only for women.
The identified differences by sex in cognitive trajectories and their associated factors suggest that men and women may require a different strategy when addressing cognitive aging.
本研究旨在记录认知健康的 55 岁及以上人群样本中认知老化的纵向轨迹。假设男女之间存在以下差异：1）认知随年龄的丧失，2）不同的轨迹识别；3）与识别轨迹相关的预测因素。
西班牙萨拉戈萨的一项 4 波、基于人群的研究（1994-2006 年）。
共 2403 名年龄在 55 岁及以上、基线时认知健康的个体。
所有参与者至少进行了 3 次简易精神状态检查（MMSE）测量。使用国际公认的经过验证的西班牙版本进行评估。对 MMSE 评分随年龄的变化进行性别差异的随机效应线性面板回归模型分析，并为每个性别独立应用增长混合模型（GMM）对纵向认知轨迹进行建模。
女性在所有阶段的 MMSE 平均得分均较低，且在第 2 至 3 阶段和第 3 至 4 阶段，MMSE 的损失明显更高。经过年龄调整的认知轨迹最佳拟合模型为男性的 4 类 GMM 和女性的 3 类 GMM。教育是男性和女性认知轨迹的预测因素。对 iADL 的依赖和酒精状况仅为男性的预测因素，而抑郁和糖尿病仅为女性的预测因素。
性别对认知轨迹及其相关因素的差异表明，男性和女性在处理认知老化时可能需要不同的策略。
