Needham, Louisa Patricia;
(2024)
Examining sex differences in cognitive
ageing and lifetime risk factors for
dementia.
Doctoral thesis (Ph.D), UCL (University College London).
Preview |
Text
Needham_10196385_Thesis.pdf Download (5MB) | Preview |
Abstract
Background: Mechanisms of increased female dementia risk are currently unclear given a paucity of research explicitly examining sex differences in cognitive and brain ageing. Methods: Using data from a mostly cognitively unimpaired cohort, the 1946 British Birth Cohort and its neuroscience sub-study, Insight 46, sex differences in life course cognitive performance and neuroimaging indicators of ageing-, vascular-, and Alzheimer’s Disease pathology-related brain health at age ~70 are examined (Chapter 3). A cumulative measure of lifetime modifiable dementia risk factor exposures is derived and tested for associations with later-life cognition and brain health in males and females (Chapter 4). The extent to which the female-specific menopause transition associates with later-life cognitive and brain health outcomes is examined (Chapter 5). Multivariable regression analyses test the extent to which life course socioeconomic, health, lifestyle, and genetic (APOE-ε4) variables contribute to associations in both sexes. Results: Females showed cognitive performance advantages across a range of assessments from childhood to later-life; socioeconomic and educational disparities suppressed female advantages. At age 70, males had smaller relative brain volumes and females had greater levels of cerebral small vessel disease (cSVD) pathology (Chapter 3). Modifiable dementia risk factor exposures, greater in males, negatively associated with later-life cognitive performance in both sexes and with smaller brain volumes in males, independently of early cognitive, socioeconomic, and APOE-ε4 predictors of risk exposures (Chapter 4). Later menopause age associated with better later-life cognitive and brain health outcomes in women (e.g. larger brain volumes), with associations partly explained by childhood cognition and health-related variables, respectively (Chapter 5). Conclusions: Sex differences in cognitive resilience to brain ageing and cSVD, and in the life course sociocultural and biological mechanisms underlying cognitive resilience, were shown. Findings advocate for the importance of sex- and gender-based analyses to understand life course pathways to dementia in males and females.
| Type: | Thesis (Doctoral) |
|---|---|
| Qualification: | Ph.D |
| Title: | Examining sex differences in cognitive ageing and lifetime risk factors for dementia |
| Open access status: | An open access version is available from UCL Discovery |
| Language: | English |
| Additional information: | Copyright © The Author 2024. Original content in this thesis is licensed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0) Licence (https://creativecommons.org/licenses/by-nc/4.0/). Any third-party copyright material present remains the property of its respective owner(s) and is licensed under its existing terms. Access may initially be restricted at the author’s request. |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10196385 |
Archive Staff Only
 |
View Item |
