Women Outperform Men in Verbal Episodic Memory Even in Oldest-Old Age: 13-Year Longitudinal Results of the AgeCoDe/AgeQualiDe Study

Article type: Research Article

Authors: Golchert, Johannes^a | Roehr, Susanne^{a; b; *} | Luck, Tobias^c | Wagner, Michael^{d; e} | Fuchs, Angela^f | Wiese, Birgitt^g | van den Bussche, Hendrik^h | Brettschneider, Christianⁱ | Werle, Jochen^j | Bickel, Horst^k | Pentzek, Michael^f | Oey, Anke^g | Eisele, Marion^h | König, Hans-Helmutⁱ | Weyerer, Siegfried^j | Mösch, Edelgard^k | Maier, Wolfgang^{d; e} | Scherer, Martin^h | Heser, Kathrin^{d; l} | Riedel-Heller, Steffi G.^{a; l}

Affiliations: [a] Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, Leipzig, Germany | [b] LIFE – Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany | [c] Department of Economic and Social Sciences & Institute of Social Medicine, Rehabilitation Sciences and Healthcare Research (ISRV), University of Applied Sciences Nordhausen, Nordhausen, Germany | [d] Department of Neurodegenerative Diseases and Geriatric Psychiatry, University of Bonn, Bonn, Germany | [e] DZNE, German Center for Neurodegenerative Diseases, Bonn, Germany | [f] Institute of General Practice, Medical Faculty, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany | [g] Work Group Medical Statistics and IT-Infrastructure, Institute for General Practice, Hannover Medical School, Hannover, Germany | [h] Department of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center, Hamburg-Eppendorf, Germany | [i] Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany | [j] Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany | [k] Department of Psychiatry, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany | [l] Joint last authors

Correspondence: [*] Correspondence to: Susanne Roehr, Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, Philipp-Rosenthal-Straße 55, 04103 Leipzig, Germany. Tel.: (+49) 341 97 24568; Fax: (+49) 341 97 24569; E-mail: susanne.roehr@medizin.uni-leipzig.de.

Abstract: Background:Sex differences in verbal episodic memory function have been widely reported. However, sex-specific effects on rates of episodic memory decline remain controversial, and evidence is particularly scarce in the oldest-old population. Objective:We aimed to investigate sex differences in trajectories of episodic memory performance in oldest-old individuals. Methods:Based on 13-year longitudinal data with 9 follow-up assessments of a large sample of cognitively unimpaired old (75+) primary care patients (n = 3,254) participating in the German AgeCoDe/AgeQualiDe study, we used linear mixed effects analyses to model sex-specific trajectories of change in verbal episodic memory while accounting for covarying factors. Results:We found that even in the highest age group women outperformed men in immediate (b = –1.71, p < 0.001) and delayed (b = –0.85, p < 0.001) free recall conditions. Associated late-life trajectories, however, did not differ significantly between the sexes. We further demonstrated that younger age, higher education, and an absence of depressive symptoms predicted better performance in both sexes. In contrast, past occurrences of stroke and APOE ɛ4 carrier status showed a negative relation to test scores. Conclusion:Our findings confirm previous research suggesting that women perform better in verbal episodic memory tests. We add that this advantage is still present in the oldest-old age groups. Our results indicate that sociodemographic and health related factors are as important as genetically based APOE ɛ4 carrier status in the prediction of normal cognitive development in advanced old age.

Keywords: Cognition, cohort study, longitudinal, oldest-old, sex differences, verbal episodic memory

DOI: 10.3233/JAD-180949

Journal: Journal of Alzheimer's Disease, vol. 69, no. 3, pp. 857-869, 2019