Gender differences in pre-mild cognitive decline in middle-aged and elderly patients

The aim of the study. Analysis of neuropsychological characteristics of patients of different sexes with pre-mild cognitive decline (PMCD), including subjective and subtle cognitive decline.

Material and methods. The study included 388 female patients with PMCD (mean age 64.75 ± 8.71 years) and 159 male patients (mean age 65.52 ± 9.41 years). A clinical psychological study was conducted using quantitative scales — the Mini-Mental State Examination (MMSE), the Frontal Assessment Battery (FAB), and memory tests — a 12 word test with immediate and delayed recall, mental process speed — a study of literal and categorical associations, a trail making test (parts A), an assessment of the nominative function of speech using the Boston Naming Test, attention — a forward and backward digit repetition test, visual-spatial functions — a clock drawing test, and execu- tive functions — a trail making test (parts B). The emotional state of patients was examined using the Beck Depression Inventory, the Spielberger Anxiety Scale, and the Neuropsychiatric Inventory-Questionnaire (NPI).

Results. Among patients with PMCD, women differed from men in better indicators of the speed of production pro- cesses, function management, and auditory-verbal memory. Women also had higher values of Beck Depression Inventory, depression indicators, and noise level according to the NPI. Men had higher indicators of arousal and disinhibition according to the NPI. Men with higher education had higher indicators of executive functions, speech, and visual-spatial functions compared to men with a high level of education. Women with a higher level of education diff ered in better indicators of memory, visual-spatial functions, and executive functions than women with a lower level of education. When examining men and women with secondary school education, some deviations in neuropsychological indicators were found only in relation to the 12 word memory test with direct reproduction with the help of women. When measuring the indicators of men and women with higher education, it was found that women diff ered from men in better indicators of speech speed, higher scores on screening scales — a brief scale for assessing the mental factor and a scale for assessing frontal dysfunction, better speed of mental processes, auditory-verbal memory. Men showed higher indicators of inhibition, and women also showed higher indicators of irritability according to the NPI data. Men and women without emotional disorders with PMCD had better indicators of executive functions.

Conclusion. Comparative analysis of cognitive characteristics in different gender groups with PMCD revealed differences in the performance of tests assessing executive functions, speed of cognitive processes and memory, with better results in women. Our study showed that the level of education affects the degree of cognitive decline and to a greater extent in women.

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