{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T17:29:22Z","timestamp":1793294962446,"version":"4.5.0"},"reference-count":61,"publisher":"American Medical Association (AMA)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"\n Importance<\/jats:title>\n Sex differences in dementia risk are unclear, but some studies have found greater risk for women.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To determine associations between sex and cognitive decline in order to better understand sex differences in dementia risk.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n This cohort study used pooled analysis of individual participant data from 5 cohort studies for years 1971 to 2017: Atherosclerosis Risk in Communities Study, Coronary Artery Risk Development in Young Adults Study, Cardiovascular Health Study, Framingham Offspring Study, and Northern Manhattan Study. Linear mixed-effects models were used to estimate changes in each continuous cognitive outcome over time by sex. Data analysis was completed from March 2019 to October 2020.<\/jats:p>\n <\/jats:sec>\n \n Exposure<\/jats:title>\n Sex.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n \n The primary outcome was change in global cognition. Secondary outcomes were change in memory and executive function. Outcomes were standardized as\n t<\/jats:italic>\n scores (mean [SD], 50 [10]); a 1-point difference represents a 0.1-SD difference in cognition.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Among 34\u202f349 participants, 26\u202f088 who self-reported Black or White race, were free of stroke and dementia, and had covariate data at or before the first cognitive assessment were included for analysis. Median (interquartile range) follow-up was 7.9 (5.3-20.5) years. There were 11\u202f775 (44.7%) men (median [interquartile range] age, 58 [51-66] years at first cognitive assessment; 2229 [18.9%] Black) and 14\u202f313 women (median [interquartile range] age, 58 [51-67] years at first cognitive assessment; 3636 [25.4%] Black). Women had significantly higher baseline performance than men in global cognition (2.20 points higher; 95% CI, 2.04 to 2.35 points;\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001), executive function (2.13 points higher; 95% CI, 1.98 to 2.29 points;\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001), and memory (1.89 points higher; 95% CI, 1.72 to 2.06 points;\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001). Compared with men, women had significantly faster declines in global cognition (\u22120.07 points\/y faster; 95% CI, \u22120.08 to \u22120.05 points\/y;\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001) and executive function (\u22120.06 points\/y faster; 95% CI, \u22120.07 to \u22120.05 points\/y;\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001). Men and women had similar declines in memory (\u22120.004 points\/y faster; 95% CI, \u22120.023 to 0.014;\n P<\/jats:italic>\n \u2009=\u2009.61).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n The results of this cohort study suggest that women may have greater cognitive reserve but faster cognitive decline than men, which could contribute to sex differences in late-life dementia.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2021.0169","type":"journal-article","created":{"date-parts":[[2021,2,25]],"date-time":"2021-02-25T12:40:55Z","timestamp":1614256855000},"page":"e210169","source":"Crossref","is-referenced-by-count":440,"title":["Sex Differences in Cognitive Decline Among US Adults"],"prefix":"10.1001","volume":"4","author":[{"given":"Deborah A.","family":"Levine","sequence":"first","affiliation":[{"name":"Cognitive Health Services Research Program, Department of Internal Medicine, University of Michigan, Ann Arbor"},{"name":"Department of Neurology and Stroke Program, University of Michigan, Ann Arbor"},{"name":"Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alden L.","family":"Gross","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily M.","family":"Brice\u00f1o","sequence":"additional","affiliation":[{"name":"Cognitive Health Services Research Program, Department of Internal Medicine, University of Michigan, Ann Arbor"},{"name":"Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor"},{"name":"Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas","family":"Tilton","sequence":"additional","affiliation":[{"name":"Cognitive Health Services Research Program, Department of Internal Medicine, University of Michigan, Ann Arbor"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruno J.","family":"Giordani","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, University of Michigan, Ann Arbor"},{"name":"Michigan Alzheimer\u2019s Disease Center, University of Michigan, Ann Arbor"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeremy B.","family":"Sussman","sequence":"additional","affiliation":[{"name":"Cognitive Health Services Research Program, Department of Internal Medicine, University of Michigan, Ann Arbor"},{"name":"Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor"},{"name":"VA Ann Arbor Healthcare System, Ann Arbor, Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rodney A.","family":"Hayward","sequence":"additional","affiliation":[{"name":"Cognitive Health Services Research Program, Department of Internal Medicine, University of Michigan, Ann Arbor"},{"name":"Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor"},{"name":"VA Ann Arbor Healthcare System, Ann Arbor, Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James F.","family":"Burke","sequence":"additional","affiliation":[{"name":"Department of Neurology and Stroke Program, University of Michigan, Ann Arbor"},{"name":"Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor"},{"name":"VA Ann Arbor Healthcare System, Ann Arbor, Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie","family":"Hingtgen","sequence":"additional","affiliation":[{"name":"Cognitive Health Services Research Program, Department of Internal Medicine, University of Michigan, Ann Arbor"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitchell S. V.","family":"Elkind","sequence":"additional","affiliation":[{"name":"Vagelos College of Physicians and Surgeons, Department of Neurology, Columbia University, New York, New York"},{"name":"Mailman School of Public Health, Department of Epidemiology, Columbia University, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer J.","family":"Manly","sequence":"additional","affiliation":[{"name":"Vagelos College of Physicians and Surgeons, Department of Neurology, Columbia University, New York, New York"},{"name":"Taub Institute for Research on Alzheimer\u2019s Disease and the Aging Brain, Columbia University, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca F.","family":"Gottesman","sequence":"additional","affiliation":[{"name":"Department of Neurology, Johns Hopkins University, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Darrell 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