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O5‐09‐02: DURATION OF DEMENTIA AND FORMAL CARE USE: EFFECTS OF AGE, GENDER, LIVING SITUATION, DEMENTIA MEDICATION AND ETHNICITY
Author(s) -
Janssen Olin,
Joling Karlijn,
Vos Stephanie J.B.,
Handels Ron,
Vermunt Lisa,
Francke Anneke,
Verheij Robert,
Verhey Frans R.J.,
Van Hout Hein PJ.,
Visser Pieter Jelle
Publication year - 2019
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2019.06.4883
Subject(s) - dementia , ethnic group , medicine , gerontology , duration (music) , population , disease , demography , health care , art , literature , sociology , anthropology , environmental health , economics , economic growth
adults. Methods: The present study uses a national sample of 3,617 individuals aged 25 years and older at baseline from the Americans’ Changing Lives Study (see Table 1). Mental status was assessed at five different time points across the 25-year study period (19862011) using five items from the Short Portable Mental Status Questionnaire. We utilize linear mixed effects regression models to define longitudinal, gender-specific cognitive trajectories, while adjusting for key sociodemographic (e.g., race, education) and health-related (e.g., diabetes, stroke) risk factors. Results: Gender differences emerge at younger ages and widen as age increases, in favor of men. Particularly, beginning at younger ages women on average made less errors and demonstrated a slower rate of mental status decline than men (b1⁄40.003, SE1⁄40.001, p<0.01). However, a cross-over effect occurs at midlife around age 55 such that women begin to make more errors than men and these differences continue into old age. Specifically, female errors become apparent around age 75, whereby men outperform women on the SPMSQ and this pattern persists into old age after controlling for sociodemographic and health conditions. This cross-over effect can be seen in Figure 1. Conclusions: In this longitudinal cohort, patterns of decline differ by gender, such that women experience some cognitive advantages earlier in life but these gains diminish with increasing age. Incorporating life course data is key to the elucidation of gender-related mechanisms in cognitive decline and impairment during the aging process. These findings represent critical, population-based evidence for influential periods where gender is associated with cognitive trajectory shifts. Future work will explore other modifiable social and health risk factors that contribute to gender variations in cognitive changes.