Sex Differences in Longitudinal Trajectories of Cognitive Aging in Zaragoza, Spain.

• What is the primary question addressed by this study? This study was intended to test, in healthy older adults, the hypothesis that differences between men and women would be found in the cognitive trajectories and the predictive factors associated with the identified trajectories. • What is the main finding of this study? This is the first study capturing the intrasex variability of cognitive aging, using the growth mixture models methodology. Differences by sex were found in the number and grouping of cognitive trajectories. Men maintained better their cognitive function, and the decline was sharper in women. The predictive factors associated with the identified trajectories were also different by sex. • What is the meaning of the finding? Men and women may require different strategies for addressing cognitive aging. The objective of this study was to document the longitudinal trajectories of cognitive aging in a sample of cognitively healthy subjects of 55 years or older. The following differences between men and women were hypothesized: 1) in the cognitive loss through aging, 2) in the distinct trajectories identified; and 3) in the predictors associated with the identified trajectories. A 4-wave, population-based study in Zaragoza, Spain (1994–2006). A total of 2,403 individuals aged 55+ years, cognitively healthy at baseline. All participants had at least three measurements with the Mini-Mental State Examination (MMSE). Validated Spanish versions of international instruments were used for assessment. Random effects linear panel regression model for analyzing differences by sex in MMSE scores through aging were performed, and growth mixture models (GMM) applied independently for each sex for modeling the longitudinal cognitive trajectories. Women showed lower mean MMSE scores in all phases and significantly higher loss in the MMSE from phases 2 to 3 and 3 to 4. The best fitting age-adjusted model of the cognitive trajectories was a 4-class GMM in men and a 3-class in women. Education was a predictor of cognitive trajectories in both men and women. Dependence on iADLs and alcohol status were predictors only for men, and depression and diabetes only for women. The identified differences by sex in cognitive trajectories and their associated factors suggest that men and women may require a different strategy when addressing cognitive aging. [ABSTRACT FROM AUTHOR]