Gender differences in risk factors for transition from mild cognitive impairment to Alzheimer's disease: A CREDOS study.
BACKGROUND
Women are subject to a disproportionate burden from Alzheimer's disease (AD) and sex differences exist in treatment response and prognosis of the disease. Yet gender-specific risk factors have not been widely studied. We aimed to investigate gender-specific risk factors for AD in subjects with mild cognitive impairment (MCI).


METHODS
Participants (n=294) with MCI were recruited from a nationwide, prospective cohort study of dementia and were followed for a median (range) of 13.8 (6.0-36.0) months. Sex-stratified associations of progression to AD with baseline characteristics were explored.


RESULTS
Seventy-four individuals (25.2%) developed incident dementia (67 AD) during follow-up. Significant risk factors for probable AD differed by sex. In men, the significant risk factors were severe periventricular white matter hyperintensities, and poorer global cognitive function. In women, older age, clinically significant depressive symptoms at baseline, and positive APOE ε4 alleles were the significant risk factors.


CONCLUSIONS
Risk factors for progression from MCI to probable AD differed in men and women. These results may translate to gender-specific preventative or therapeutic strategies for patients with MCI.
Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Sangha
S
Kim
Biostatistics Team, Samsung Biomedical Research Institute, Seoul, Korea.
Min Ji
MJ
Kim
Biostatistics Team, Samsung Biomedical Research Institute, Seoul, Korea.
Seonwoo
S
Kim
Center for Clinical Research, Samsung Biomedical Research Institute, Seoul, Korea.
Hyo Shin
HS
Kang
SAHIST, Sungkyunkwan University School of Medicine, Seoul, Korea.
Shin Won
SW
Lim
Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Woojae
W
Myung
Department of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon, Korea.
Yunhwan
Y
Lee
Department of Psychiatry, Ajou University School of Medicine, Suwon, Korea.
Chang Hyung
CH
Hong
Department of Neurology, Inha University School of Medicine, Incheon, Korea.
Seong Hye
SH
Choi
Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Duk L
DL
Na
Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Sang Won
SW
Seo
Department of Neurology, Myungji Hospital, Gyeonggi, Korea.
Bon D
BD
Ku
Department of Psychiatry, University of Ulsan College of Medicine Asan Medical Center, Seoul, Korea.
Seong Yoon
SY
Kim
Department of Neurology, Seoul National University Bundang Hospital, Seongnam, Korea.
Sang Yun
SY
Kim
Department of Neurology, Ewha Womans University School of Medicine, Seoul, Korea.
Jee Hyang
JH
Jeong
Department of Neurology, Soonchunhyang University Bucheon Hospital, Bucheon, Korea.
Sun Ah
SA
Park
Pacific Behavioral Research Foundation, Carmel, CA, USA.
Bernard J
BJ
Carroll
Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. Electronic address: paulkim@skku.edu.
Doh Kwan
DK
Kim
D000368:Aged; D000544:Alzheimer Disease / Q000209:etiology / Q000473:pathology / Q000523:psychology*; D003071:Cognition; D060825:Cognitive Dysfunction / Q000473:pathology / Q000523:psychology*; D003704:Dementia; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D011446:Prospective Studies; D056910:Republic of Korea; D012307:Risk Factors; D012737:Sex Factors