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LIFESTYLE AFFECTS AMYLOID BURDEN AND COGNITION DIFFERENTLY IN MEN AND WOMEN
Abstract
Aims
The aggregation of amyloid-β is hypothesized to be an early event that might eventually pave the way to clinical Alzheimer’s disease. To understand factors that aid personalized disease prevention we studied a healthy elderly population to examine the influence of lifestyle factors on brain amyloid burden and cognition specifically testing for different associations among women and men.
Methods
178 cognitively normal individuals (women, 49%; 65.0 [7.6] years) and 54 individuals with mild cognitive impairment (women, 35%; 71.3 [8.3] years) enrolled in a prospective population-based study who completed 18F-Flutemetamol amyloid positron emission tomography. Using structural equation modeling, we examined the ability of latent constructs representing metabolic/vascular risk, physical activity, and cognitive activity to predict global amyloid burden and cognitive performance. Further, we examined the moderating effect of sex.
Results
Overall, higher cognitive activity predicted better cognitive performance and higher physical activity predicted lower amyloid burden. When we subsequently examined the moderating effect of sex in the model, we revealed an inverse association of metabolic/vascular risk with cognition in men and a tendency towards higher amyloid burden in women. Further, an inverse association between physical activity and amyloid burden was found only in men whereas the apolipoprotein epsilon 4 allele predicted higher amyloid burden only in women.
Conclusions
Sex moderates effects of certain lifestyle-related factors on amyloid burden and cognition. Most importantly, our results suggest that the negative impact of metabolic/vascular risk influences the risk of cognitive decline and Alzheimer’s disease through distinct paths in women and men.