Sex differences in health-related quality of life among individuals at high risk of dementia.

Purpose: Dementia represents an increasing challenge to health systems globally, with a notable impact on health-related quality of life (HRQoL). Nevertheless, the potential effect of sex on the relation between individuals' characteristics and HRQoL, particularly in the early stages of this disease, remains unclear. Therefore, the present study aims to evaluate the association between sociodemographic, lifestyle and health-related factors with HRQoL among individuals at high risk of dementia, according to sex.

Methods: This cross-sectional study was based on baseline data from the MIND-Matosinhos randomized controlled trial, targeting Portuguese adults at high risk of dementia [n = 207; 59.9% female; median age = 70.0 (interquartile range: 11)]. HRQoL was measured using the EQ-5D-5L. The associations between explanatory variables and HRQoL scores (dichotomized by the median) were quantified through odds ratios (OR) and 95% confidence intervals (CI), stratified by sex.

Results: Overall, females reported lower HRQoL when compared with males [median (interquartile range): 0.875 (0.190) vs. 0.923 (0.129); p = 0.004]. Problems in mobility (43.6% vs. 27.7%; p = 0.021), pain/discomfort (71.8% vs. 44.6%; p < 0.001) and anxiety/depression (66.9% vs. 45.8%; p = 0.002), as well as the existence of any problem in five dimensions (7.3% vs. 3.6%; p = 0.004), were more frequently referred by females than males. A stronger association between poorer self-perceived health status and lower HRQoL was observed among females (OR = 8.75, 95% CI:3.64-21.03) compared to males (OR = 1.88, 95% CI:0.72-4.89; p for interaction = 0.020).

Conclusion: Health status is associated with HRQoL, distinctively amongst males and females. These findings emphasize the need for sex-specific public health strategies to improve HRQoL in a vulnerable population of individuals at high risk of dementia.