New research from France suggests that men and women have different risks for mild cognitive impairment (MCI) and progression to dementia. The researchers suggest stroke is a primary risk factor for men, and depression for women.

The study is the work of Dr Karen Ritchie, of the Université de Montpellier and La Colombière Hospital in Montpellier, and colleagues, and is published online ahead of print today, 1st May, in the Journal of Neurology, Neurosurgery, and Psychiatry.

The researchers carried out a prospective community based study over four years of 6,892 men and women aged 65 and over living in three cities in France.

None of the participants had dementia when enrolled on the study (baseline), and they all underwent cognitive performance tests, clinical diagnosis for dementia, and evaluation of clinical and environmental risk factors at baseline, year 2, and year 4 of the study.

The results showed that:

  • 42 per cent of the participants had MCI at baseline.

  • Ruling out confounding factors showed that men and women with MCI were more likely to have symptoms of depression and to be taking anticholinergic drugs (these are used to treat symptoms like ulcers, stomach cramps, motion sickness, and urinary incontinence).

  • Men with MCI were more likely to have higher BMI, have diabetes and stroke.

  • Women with MCI, on, the other hand, were more likely to have poor subjective health, to be disabled, socially isolated, and suffer from poor quality sleep.

  • For progression from MCI to dementia, the main risk-adjusted factors for men were presence of the ApoE4 gene (3.2 times higher risk), stroke (2.8 times higher risk), low level of education (2.3 times higher risk), loss of ability to carry out daily tasks (2.2 times higher risk), and age (1.2 times higher risk).

  • For women, the main risk-adjusted factors influencing progression from MCI to dementia, were loss of ability to carry out daily tasks (3.5 times higher risk), presence of ApoE4 gene (2.3 times higher risk), low level of education (2.2 times higher risk), subclinical depression (2.0 times higher risk), use of anticholinergic drugs (1.8 times higher risk), and age (1.1 times higher risk).

The researchers concluded that:

“Men and women have different risk profiles for both MCI and progression to dementia.”

They recommended that interventions should:

“Focus principally on risk of stroke in men and depressive symptomatology and use of anticholinergic medication in women.”

“Risk profiles for mild cognitive impairment and progression to dementia are gender specific.”
Artero, S, Ancelin, M-L, Portet, F, Dupuy, A, Berr, C, Dartigues, J-F, Tzourio, C, Rouaud, O, Poncet, M, Pasquier, F, Auriacombe, S, Touchon, J, Ritchie, K.
J Neurol Neurosurg Psychiatry Published Online First on 01 May 2008.
DOI:10.1136/jnnp.2007.136903.

click here for Abstract.

Sources: journal abstract.

Written by: Catharine Paddock, PhD