Sangha Kim1, Min Ji Kim2, Seonwoo Kim2, Hyo Shin Kang3, Shin Won Lim4, Woojae Myung1, Yunhwan Lee5, Chang Hyung Hong6, Seong Hye Choi7, Duk L Na8, Sang Won Seo8, Bon D Ku9, Seong Yoon Kim10, Sang Yun Kim11, Jee Hyang Jeong12, Sun Ah Park13, Bernard J Carroll14, Doh Kwan Kim15. 1. Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. 2. Biostatistics Team, Samsung Biomedical Research Institute, Seoul, Korea. 3. Center for Clinical Research, Samsung Biomedical Research Institute, Seoul, Korea. 4. SAHIST, Sungkyunkwan University School of Medicine, Seoul, Korea. 5. Department of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon, Korea. 6. Department of Psychiatry, Ajou University School of Medicine, Suwon, Korea. 7. Department of Neurology, Inha University School of Medicine, Incheon, Korea. 8. Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. 9. Department of Neurology, Myungji Hospital, Gyeonggi, Korea. 10. Department of Psychiatry, University of Ulsan College of Medicine Asan Medical Center, Seoul, Korea. 11. Department of Neurology, Seoul National University Bundang Hospital, Seongnam, Korea. 12. Department of Neurology, Ewha Womans University School of Medicine, Seoul, Korea. 13. Department of Neurology, Soonchunhyang University Bucheon Hospital, Bucheon, Korea. 14. Pacific Behavioral Research Foundation, Carmel, CA, USA. 15. Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. Electronic address: paulkim@skku.edu.
Abstract
BACKGROUND: Women are subject to a disproportionate burden from Alzheimer's disease (AD) and sex differences exist in treatment response and prognosis of the disease. Yet gender-specific risk factors have not been widely studied. We aimed to investigate gender-specific risk factors for AD in subjects with mild cognitive impairment (MCI). METHODS: Participants (n=294) with MCI were recruited from a nationwide, prospective cohort study of dementia and were followed for a median (range) of 13.8 (6.0-36.0) months. Sex-stratified associations of progression to AD with baseline characteristics were explored. RESULTS: Seventy-four individuals (25.2%) developed incident dementia (67 AD) during follow-up. Significant risk factors for probable AD differed by sex. In men, the significant risk factors were severe periventricular white matter hyperintensities, and poorer global cognitive function. In women, older age, clinically significant depressive symptoms at baseline, and positive APOE ε4 alleles were the significant risk factors. CONCLUSIONS: Risk factors for progression from MCI to probable AD differed in men and women. These results may translate to gender-specific preventative or therapeutic strategies for patients with MCI.
BACKGROUND:Women are subject to a disproportionate burden from Alzheimer's disease (AD) and sex differences exist in treatment response and prognosis of the disease. Yet gender-specific risk factors have not been widely studied. We aimed to investigate gender-specific risk factors for AD in subjects with mild cognitive impairment (MCI). METHODS:Participants (n=294) with MCI were recruited from a nationwide, prospective cohort study of dementia and were followed for a median (range) of 13.8 (6.0-36.0) months. Sex-stratified associations of progression to AD with baseline characteristics were explored. RESULTS: Seventy-four individuals (25.2%) developed incident dementia (67 AD) during follow-up. Significant risk factors for probable AD differed by sex. In men, the significant risk factors were severe periventricular white matter hyperintensities, and poorer global cognitive function. In women, older age, clinically significant depressive symptoms at baseline, and positive APOE ε4 alleles were the significant risk factors. CONCLUSIONS: Risk factors for progression from MCI to probable AD differed in men and women. These results may translate to gender-specific preventative or therapeutic strategies for patients with MCI.
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