{"title":"认知储备的性别差异：对主观认知衰退进展的影响？","authors":"Giacomucci Giulia, Moschini Valentina, Ceccarelli Alice, Padiglioni Sonia, Morinelli Carmen, Mazzeo Salvatore, Crucitti Chiara, Galdo Giulia, Emiliani Filippo, Bagnoli Silvia, Ingannato Assunta, Marcantelli Elisa, Nacmias Benedetta, Sorbi Sandro, Bessi Valentina","doi":"10.1002/dad2.70174","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>This study investigated gender differences in cognitive reserve (CR) in subjective cognitive decline (SCD) and examined the impact of gender-CR interaction on the risk of progression to mild cognitive impairment (MCI).</p><p><strong>Methods: </strong>We enrolled 440 SCD patients and estimated CR using premorbid intelligence (<i>Test di Intelligenza Breve</i> [TIB]). To account for socio-cultural differences, patients were stratified by birth cohort (pre-/post-1950). A Markov random-field (MRF) model explored relationships between gender, CR, education, and age. Logistic regression assessed MCI progression risk.</p><p><strong>Results: </strong>Women showed lower TIB scores than men (<i>p </i>< 0.001). The MRF model revealed an inverse connection between TIB and female gender, while no link was observed between TIB and generation. Progression to MCI was predicted by age at onset (<i>p </i>< 0.001), apolipoprotein E (<i>APOE)</i> status (<i>p </i>= 0.002), and TIB (<i>p </i>= 0.018), but not gender.</p><p><strong>Discussion: </strong>Gender has an impact on CR, but not through socio-economic variables. In turn, CR influenced the risk of MCI progression, whereas gender did not.</p><p><strong>Highlights: </strong>Subjective cognitive decline (SCD) women presented lower cognitive reserve (CR) levels than men, despite similar education levels.Social-cultural factors did not explain these gender differences in CR in SCD.The gender-CR interaction was not mediated by social-cultural factors.The risk of progression to mild cognitive impairment (MCI) was influenced by CR but not by gender.</p>","PeriodicalId":53226,"journal":{"name":"Alzheimer''s and Dementia: Diagnosis, Assessment and Disease Monitoring","volume":"17 3","pages":"e70174"},"PeriodicalIF":4.4000,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12381356/pdf/","citationCount":"0","resultStr":"{\"title\":\"Gender differences in cognitive reserve: An impact on progression in subjective cognitive decline?\",\"authors\":\"Giacomucci Giulia, Moschini Valentina, Ceccarelli Alice, Padiglioni Sonia, Morinelli Carmen, Mazzeo Salvatore, Crucitti Chiara, Galdo Giulia, Emiliani Filippo, Bagnoli Silvia, Ingannato Assunta, Marcantelli Elisa, Nacmias Benedetta, Sorbi Sandro, Bessi Valentina\",\"doi\":\"10.1002/dad2.70174\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>This study investigated gender differences in cognitive reserve (CR) in subjective cognitive decline (SCD) and examined the impact of gender-CR interaction on the risk of progression to mild cognitive impairment (MCI).</p><p><strong>Methods: </strong>We enrolled 440 SCD patients and estimated CR using premorbid intelligence (<i>Test di Intelligenza Breve</i> [TIB]). To account for socio-cultural differences, patients were stratified by birth cohort (pre-/post-1950). A Markov random-field (MRF) model explored relationships between gender, CR, education, and age. Logistic regression assessed MCI progression risk.</p><p><strong>Results: </strong>Women showed lower TIB scores than men (<i>p </i>< 0.001). The MRF model revealed an inverse connection between TIB and female gender, while no link was observed between TIB and generation. Progression to MCI was predicted by age at onset (<i>p </i>< 0.001), apolipoprotein E (<i>APOE)</i> status (<i>p </i>= 0.002), and TIB (<i>p </i>= 0.018), but not gender.</p><p><strong>Discussion: </strong>Gender has an impact on CR, but not through socio-economic variables. In turn, CR influenced the risk of MCI progression, whereas gender did not.</p><p><strong>Highlights: </strong>Subjective cognitive decline (SCD) women presented lower cognitive reserve (CR) levels than men, despite similar education levels.Social-cultural factors did not explain these gender differences in CR in SCD.The gender-CR interaction was not mediated by social-cultural factors.The risk of progression to mild cognitive impairment (MCI) was influenced by CR but not by gender.</p>\",\"PeriodicalId\":53226,\"journal\":{\"name\":\"Alzheimer''s and Dementia: Diagnosis, Assessment and Disease Monitoring\",\"volume\":\"17 3\",\"pages\":\"e70174\"},\"PeriodicalIF\":4.4000,\"publicationDate\":\"2025-08-26\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12381356/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Alzheimer''s and Dementia: Diagnosis, Assessment and Disease Monitoring\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1002/dad2.70174\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/7/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q1\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Alzheimer''s and Dementia: Diagnosis, Assessment and Disease Monitoring","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1002/dad2.70174","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/7/1 0:00:00","PubModel":"eCollection","JCR":"Q1","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0
摘要
本研究探讨了主观认知衰退（SCD）患者认知储备（CR）的性别差异，并探讨了性别-CR交互作用对进展为轻度认知障碍（MCI）风险的影响。方法：我们招募了440名SCD患者，并使用病前智力测试（Test di Intelligenza Breve [TIB]）估计CR。为了考虑社会文化差异，患者按出生队列（1950年前/ 1950年后）分层。一个马尔可夫随机场（MRF）模型探讨了性别、CR、教育和年龄之间的关系。Logistic回归评估MCI进展风险。结果：女性TIB评分低于男性（p = 0.002）， TIB评分低于男性（p = 0.018），但与性别无关。讨论：性别对CR有影响，但不是通过社会经济变量。反过来，CR影响轻度认知障碍进展的风险，而性别没有影响。重点：尽管受教育程度相似，但主观认知衰退（SCD）女性的认知储备（CR）水平低于男性。社会文化因素不能解释SCD患者CR的性别差异。性别- cr交互作用不受社会文化因素的调节。进展为轻度认知障碍（MCI）的风险受CR影响，但不受性别影响。
Gender differences in cognitive reserve: An impact on progression in subjective cognitive decline?
Introduction: This study investigated gender differences in cognitive reserve (CR) in subjective cognitive decline (SCD) and examined the impact of gender-CR interaction on the risk of progression to mild cognitive impairment (MCI).
Methods: We enrolled 440 SCD patients and estimated CR using premorbid intelligence (Test di Intelligenza Breve [TIB]). To account for socio-cultural differences, patients were stratified by birth cohort (pre-/post-1950). A Markov random-field (MRF) model explored relationships between gender, CR, education, and age. Logistic regression assessed MCI progression risk.
Results: Women showed lower TIB scores than men (p < 0.001). The MRF model revealed an inverse connection between TIB and female gender, while no link was observed between TIB and generation. Progression to MCI was predicted by age at onset (p < 0.001), apolipoprotein E (APOE) status (p = 0.002), and TIB (p = 0.018), but not gender.
Discussion: Gender has an impact on CR, but not through socio-economic variables. In turn, CR influenced the risk of MCI progression, whereas gender did not.
Highlights: Subjective cognitive decline (SCD) women presented lower cognitive reserve (CR) levels than men, despite similar education levels.Social-cultural factors did not explain these gender differences in CR in SCD.The gender-CR interaction was not mediated by social-cultural factors.The risk of progression to mild cognitive impairment (MCI) was influenced by CR but not by gender.
期刊介绍：
Alzheimer''s & Dementia: Diagnosis, Assessment & Disease Monitoring (DADM) is an open access, peer-reviewed, journal from the Alzheimer''s Association® that will publish new research that reports the discovery, development and validation of instruments, technologies, algorithms, and innovative processes. Papers will cover a range of topics interested in the early and accurate detection of individuals with memory complaints and/or among asymptomatic individuals at elevated risk for various forms of memory disorders. The expectation for published papers will be to translate fundamental knowledge about the neurobiology of the disease into practical reports that describe both the conceptual and methodological aspects of the submitted scientific inquiry. Published topics will explore the development of biomarkers, surrogate markers, and conceptual/methodological challenges. Publication priority will be given to papers that 1) describe putative surrogate markers that accurately track disease progression, 2) biomarkers that fulfill international regulatory requirements, 3) reports from large, well-characterized population-based cohorts that comprise the heterogeneity and diversity of asymptomatic individuals and 4) algorithmic development that considers multi-marker arrays (e.g., integrated-omics, genetics, biofluids, imaging, etc.) and advanced computational analytics and technologies.
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