January 25, 2012

expert reaction to study of gender and mild memory loss in old age as published in Neurology

A paper in Neurology which suggested that men are at higher risk of the earliest signs of dementia, when compared to women.

Dr Celeste de Jager, Senior Neuropsychologist, OPTIMA (Oxford Project to Investigate Memory and Ageing), University of Oxford, said:

“The Mayo clinic work on MCI is well regarded, as the concept of MCI originated with Ronald Petersen, so the diagnostic criteria and methods used to assess the cognitive status of participants in the study are sound.

“It is interesting that although the results for the incidence of MCI were significantly higher for men than for women, the incidence of dementia remains higher for women. The Rockwood editorial discusses reasons for this, one being that there is possibly an ongoing attempt to restore the balance of ‘insult’ and ‘repair’ in the brain. He suggests that men might resist development and progression of dementia more than women. For instance, men benefit from exercise more in terms of cognitive health than women, while for women exercise delays death.

“Comparison with other cohort studies in Europe were not entirely consistent in confirming that men are at higher risk of MCI than women. Factors such as education, marital status, diet and exercise will add variability to individual risk, therefore men should not get overly concerned about their relative risk of dementia as compared to women’s risk if they are experiencing memory problems. As the paper shows that men were at twice the risk for non-amnestic MCI (with problems in planning, judgement and carrying out complex tasks), which is less likely to progress to Alzheimer’s disease than amnestic MCI (with predominant memory loss), overall, their risk of developing Alzheimer’s disease should not be higher than that of women.

“However, the important message of the paper is that studies ought to analyse data relating to risk factors for MCI separately for men and women in order to discover new insights into the different interactions of factors such as age and sex, education and sex, and different risk factors for amnestic and non-amnestic MCI. New findings may impact on management and treatment possibilities to delay progression to dementia.”

Dr Nadja Reissland, Senior lecturer in Psychology, Durham University, said:

“My research concerns maternal stress and depression and infant development. It is interesting for me that there were many more males (1626 males) than females (497) in the sample.

“Nevertheless, the results indicate depression levels in females are associated with long working hours. Additionally the females showing depression were younger than depressed males in the sample of 35-55 years olds studied.

“However, it is unclear how many of the women had children or were pregnant. Could it be that women who are reaching the end of their fertility and who want to have a family will be more depressed when working long hours compared with women who have an established family (perhaps with older children)?”

Derek Hill, Professor of Medical Imaging Science, University College London, said:

“More women get dementia than men. Yet this new research shows that more men than women develop a complaint called Mild Cognitive Impairment (MCI), frequently an early warning sign of dementia. Perhaps these gender differences, if better understood, could provide a clue to new ways preventing dementia.

“By the time people get clinical dementia, it may well be too late to treat them. People with “Mild Cognitive Impairment” or MCI are known to be at high risk of developing dementia. This study shows that MCI is a very complicated mix of factors, and that different types of MCI arise and progress quite differently. This information could be important in improving diagnosis to identify patients who will benefit from current or future treatments.”

Dr Anne Corbett, Research Manager, Alzheimer’s Society, said:

“Increasing our understanding of mild cognitive impairment (MCI) could help us unravel the many mysteries still surrounding Alzheimer’s disease and move us closer to treatments and a cure. This exciting research adds to previous evidence that men could be more susceptible to MCI than women. However we now need further research into why this is the case.

“One in three people over 65 will die with dementia and by 2021 there will be over a million people in the UK with the condition. Yet dementia research remains drastically underfunded. Only through more research can we find out more about MCI and its relationship with Alzheimer’s disease. We must invest now.”

Further information from the Alzheimer’s Society: Men are more likely to develop mild cognitive impairment than women, study claims Mild cognitive impairment (MCI) may affect more men than women research published in the journal Neurology claims today (Wednesday 25 January 2012). 1,450 people who had no signs of cognitive impairment were revaluated 15 months later. Men were 26% more likely to develop MCI than women, and 32% more likely to develop MCI with memory problems. The study also found that people with a low level of education (12 years in education or fewer) had a higher rate of MCI. MCI includes problems with memory or thinking beyond that explained by the normal rate of ageing and often leads to Alzheimer’s disease.
‘The incidence of MCI differs by subtype and is higher in men’ by Roberts et al. published in Neurology on Wednesday 25th January.