A publication on the association between Sex/Gender and Cognitive Decline won the 2023 Publication of the Year Award


A publication on the association between Sex/Gender and Cognitive Decline
won the 2023 Publication of the Year Award

On behalf of the International Society to Advance Alzheimer’s Research and Treatment Design and Data Analytics PIA, the publication titled ‘How Selection Over Time Contributes to the Inconsistency of the Association Between Sex/Gender and Cognitive Decline Across Cognitive Aging Cohorts’ published in the American Journal of Epidemiology has been selected as the recipient of the 2023 Publication of the Year Award.

The association between sex/gender and age-related cognitive decline remains poorly understood due to contradictory results in the literature.
This disparity may be explained by the diversity of cognitive functions studied and the characteristics of the populations studied, but also by differential selection between men and women due to study exit and death.
The present study, initiated during the 2018 annual meeting of MELODEM (MEthods in LOngitudinal DEMentia research) initiative, aimed to assess the impact of selection by exit and death on the association between sex/gender and cognitive decline.
We first compared the most frequently used statistical methods for longitudinal data, targeting either population estimators (marginal models estimated by generalised estimating equations) or subject-specific estimators (mixed/conjoint models estimated by maximum likelihood) in 8 studies of ageing: 6 population-based cohorts (ACTIVE (1), PAQUID (2), REGARDS (3), 3Cités-Bordeaux (4), WHICAP (5) Whitehall II (6)) and 2 clinical studies (ADNI (7), MEMENTO (8)).
We illustrate the differences between estimators of the association between sex/gender and cognitive decline using selected examples and highlight the crucial role of differential selection by study exit and death.
Using the same estimator, we then contrast the associations between sex/gender and cognitive decline across cohorts and cognitive measures, suggesting a residual differential association between sex/gender as a function of the targeted cognitive measure (memory or animal fluency) and initial cohort selection.
We recommend targeting subject-specific estimators in the living population to assess sex/gender differences while accounting for differential selection over time.

Link to publication



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Anais Rouanet anais.rouanet@u-bordeaux.fr
Cecile Proust-Lima cecile.proust-lima@u-bordeaux.fr