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Cognitive Dysfunction, Gender, and Neuropsychiatric Symptoms in Alzheimer's Disease
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Alzheimer’s disease (AD) is associated with progressive cognitive declines that classically affect memory in the mild stages of the disease and gradually impair all other cognitive functions. Although certain changes in cognitive abilities are known to be associated with AD, better characterization of how cognitive functions become impaired relative to each other is needed to improve our understanding of AD. It is also vital to better understand how and why AD affects women differently than men. Almost two-thirds of individuals with AD in the United States are women, and several studies have shown that women are at higher risk of developing AD. Among those with AD, women seem to have worse cognitive deficits than men. It is unclear why women may be more vulnerable to AD than men. The potential contribution of neuropsychiatric symptoms to the gender gap in AD has not been considered carefully. Neuropsychiatric symptoms (e.g., depression, anxiety) are commonly experienced by individuals with AD, but these emotional symptoms often differ between men and women. Furthermore, neuropsychiatric symptoms are associated with risk for AD and accelerated cognitive deterioration. Neuropsychiatric symptoms may mediate the gender gap in AD, but this hypothesis has not been analyzed. Given these important, unanswered questions about the relationships among cognitive dysfunction, gender, and neuropsychiatric symptoms in AD, the current research (1) developed cross-sectional and longitudinal models of AD-associated cognitive dysfunction, (2) analyzed gender differences in these models, (3) examined whether neuropsychiatric symptoms mediated any gender differences in AD-associated cognitive dysfunction, and (4) analyzed whether gender or neuropsychiatric symptoms predicted conversion from non-demented aging to AD. Results indicated that individuals with AD experienced linear cognitive decline over a two-year period. Among individuals with AD, women had worse memory performance and exhibited faster rates of memory decline than men. Neuropsychiatric symptoms did not mediate these gender effects on AD-associated cognitive dysfunction, but they did increase odds of conversion from non-demented aging to AD. However, gender did not predict likelihood of converting to AD. Overall, this study suggested that AD-afflicted women may suffer from worse memory dysfunction than their male counterparts, even when controlling for dementia severity.
mild cognitive impairment
Lowe, Deborah Anne (2017). Cognitive Dysfunction, Gender, and Neuropsychiatric Symptoms in Alzheimer's Disease. Doctoral dissertation, Texas A & M University. Available electronically from