Tuesday, March 17, 2015

Memory is worse in men than women, especially after 40.

JAMA: A study of brain aging finds that being male was associated with worse memory and lower hippocampal volume in individuals who were cognitively normal at baseline, while the gene APOE ɛ4, a risk factor for Alzheimer disease, was not, according to an article published online by JAMA Neurology.
Typical cognitive aging may be defined as age-associated changes in cognitive performance in individuals free of dementia. To assess brain imaging findings associated with typical aging, the full adult age spectrum should be included, according to the study background.


The authors found:
  • Overall memory worsened from age 30 through the 90s.
  • HVa worsened gradually from age 30 to the mid-60s and more steeply after that with advancing age.
  • Median amyloid accumulation seen on PET scans was low until age 70 but increased after that.
  • Memory was worse in men than women overall, especially after 40.
  • The HVa was lower in men than women overall, especially after 60.
  • For both males and females, memory performance and HVa were not different by APOE ɛ4 carrier status at any age.
  • From age 70 onward, APOE ɛ4 carriers had greater median amyloid accumulation seen on PET scans than noncarriers.
  • The ages at which 10 percent of the population was “amyloid PET positive” were 57 years for APOE ɛ4 carriers and 64 years for noncarriers. Amyloid PET positive indicates individuals are accumulating amyloid in their brain as seen on PET scans and, while they may be asymptomatic, they are at risk for Alzheimer disease.
“We believe that this study of typical aging reveals interesting sex and APOE ɛ4 effects on age-related trends in brain structure, function and β-amyloidosis [buildup of plaque deposits in the brain]. To date, these effects have not been widely appreciated. Our findings are consistent with a model of late-onset AD [Alzheimer disease] in which β-amyloidosis arises later in life on a background of preexisting structural and cognitive decline that is associated with aging and not with β-amyloid deposits,” the study concludes.
(JAMA Neurol. Published online March 16, 2015. doi:10.1001/jamaneurol.2014.4821. Available pre-embargo to the media at http://media.jamanetwork.com.)