Differential effects of sex on longitudinal patterns of cognitive decline in Parkinson's disease
| Autor: | Anastazja M. Gorecki, Malcolm K. Horne, Alexa Jefferson, R. Stell, Jade E. Kenna, Paola Chivers, Megan C. Bakeberg, Sarah McGregor, Frank L. Mastaglia, Michelle L. Byrnes, Sue Walters, Samantha J. Winter, Soumya Ghosh, Ryan S. Anderton |
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| Rok vydání: | 2020 |
| Předmět: |
0301 basic medicine
Male Longitudinal study Domain specific Parkinson's disease Cross-sectional study Cognitive decline Neuropsychological Tests 03 medical and health sciences 0302 clinical medicine medicine Dementia Humans Cognitive Dysfunction Effects of sleep deprivation on cognitive performance Longitudinal Studies Original Communication Australia Repeated measures design Cognition Parkinson Disease medicine.disease 030104 developmental biology Cross-Sectional Studies Neurology Parkinson’s disease Longitudinal Female Sex Neurology (clinical) Psychology 030217 neurology & neurosurgery Clinical psychology |
| Zdroj: | Journal of Neurology |
| ISSN: | 1432-1459 |
| Popis: | Background Cognitive impairment is an important and diverse symptom of Parkinson’s disease (PD). Sex is a purported risk variable for cognitive decline in PD, but has not been comprehensively investigated. Objectives This cross-sectional and longitudinal study examined sex differences in global and domain-specific cognitive performance in a large PD cohort. Methods Cognitive function was evaluated using the Addenbrooke’s Cognitive Examination in 392 people with PD (PwP) from the Australian Parkinson’s Disease Registry. The influence of sex on domain-specific cognitive performance was investigated using covariate-corrected generalised linear models. In a repeated measures longitudinal subset of 127 PwP, linear mixed models were used to assess the impact of sex on cognition over time, while accounting for covariates. Results Cross-sectional-corrected modelling revealed that sex was significantly predictive of cognitive performance, with males performing worse than females on global cognition, and memory and fluency domains. Longitudinally, sex was significantly predictive of cognitive decline, with males exhibiting a greater reduction in global cognition and language, whereas females showed a greater decline in attention/orientation, memory and visuospatial domains, despite starting with higher baseline scores. At follow-up, a significantly higher proportion of males than females fulfilled criteria for mild cognitive impairment or PD dementia. Conclusions Sex was revealed as a significant determinant of overall cognitive performance as well as specific cognitive domains, with a differential pattern of decline in male and female participants. Such sex-specific findings appear to explain some of the heterogeneity observed in PD, warranting further investigation of mechanisms underlying this sexual dimorphism. |
| Databáze: | OpenAIRE |
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