Sex differences in cognitive impairment and Alzheimer's disease

Abstract

Studies have shown differences in specific cognitive ability domains and risk of Alzheimer's disease between the men and women at later age. However it is important to know that sex differences in cognitive function during adulthood may have their basis in both organizational effects, i.e., occurring as early as during the neuronal development period, as well as in activational effects, where the influence of the sex steroids influence brain function in adulthood. Further, the rate of cognitive decline with aging is also different between the sexes. Understanding the biology of sex differences in cognitive function will not only provide insight into Alzheimer's disease prevention, but also is integral to the development of personalized, gender-specific medicine. This review draws on epidemiological, translational, clinical, and basic science studies to assess the impact of sex differences in cognitive function from young to old, and examines the effects of sex hormone treatments on Alzheimer's disease in men and women.

Keywords: Alzheimer’s disease; Cognition; Gender; Sex difference; Steroid hormones.

Figure 1

Spatial rotation tasks with simple 2-dimensianl stimuli (A) or complex 3-dimensianl stimuli (B). In tests, two or more objects were either identical or mirror images of each other were placed at different orientation in space with varying degrees of angular disparity. Spatial navigation tests through virtual park (C) or virtual maze (D) as a determinant of capability in allocentric and egocentric memory, respectively. Object location test at a easy (E) or a difficulty (F) trials are shown for feature stimuli.