According to a study published in the Journal of Neurology Neurosurgery and Psychiatry, men and women have different risk factors that contribute to the development of Alzheimer's disease and dementia. The French researchers found that stroke is a main risk factor for men and depression is a critical factor for women.

The researchers analyzed a sample of almost 7000 people over age 65 from three French cities. None of the patients had dementia, but about 40% had some type of mild cognitive impairment (MCI) that affected their mental agility. Patients were evaluated at the start of the study, and the researchers monitored their progress two and four years later.

Of the patients in the sample who were considered to have some type of cognitive impairment, over 6.5% developed dementia over the next four years. There was no change noted in about 50% of the patients, and about 33% actually returned to normal levels of cognitive agility.

The researchers found that depressed patients and those taking anticholinergic medications (interfering with chemical signals in the brain) were more likely to decline from mild cognitive impairment to dementia. In addition, people who had a particular variation in the ApoE gene - known to be a risk factor for dementia - were more likely to progress from mil cognitive impairment to dementia.

A key finding was that these risk factors were different for males and females. Mild cognitive impairment in men was associated with being overweight, having diabetes, and having a history of stroke. Further, the researchers found that having had a stroke increased the likelihood of a male's progression to dementia by a factor of three.

Among the women, mild cognitive impairment was associated with being in poorer general health, being disabled, having insomnia, and having a poor support network. Women who could not perform routine daily tasks were 3.5 times as likely to progress to dementia, and depressed women were two times as likely to progress.

Although stroke occurs at a similar rate in both men and women, it was not found to be a risk factor for dementia in women.

"Some potentially reversible risk factors for progression to dementia were identified, which were not the same for men and women (notably stroke in men and subclinical depression and use of anticholinergic drugs in women). These factors should be taken into account in the development of gender-specific clinical intervention programmes for MCI," conclude the authors.

Risk profiles for mild cognitive impairment and progression to dementia are gender specific
S Artero, M-L Ancelin, F Portet, A Dupuy, C Berr, J-F Dartigues, C Tzourio, O Rouaud, M Poncet, F Pasquier, S Auriacombe, J Touchon, K Ritchie
Journal of Neurology Neurosurgery and Psychiatry. (2008)
doi 10.1136/jnnp.2007.1369The TheWi03
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: Peter M Crosta

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