05/11/2015 12:24 EDT | Updated 05/12/2016 05:59 EDT

Women's Health in Middle Age Can Harm Memory in Late Life

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When I last wrote on this topic, I explained the bottom line of men and women NOT differing in their incidence (or propensity to getting) Alzheimer's disease. The latest results from the Mayo Clinic's analysis of their large database following older Olmsted County residents identified a difference in the risk factors for each sex to develop memory complaints. This just in, published in the journal Neurology on April 7, 2015 (vol 84, pp. 1433-1442).

Please note the risks are for starting to note memory problems, which is not the same as developing Alzheimer's disease! Mild cognitive impairment (MCI) is not one in the same as Alzheimer's disease (AD). Mild cognitive impairment criteria include an awareness of not having the same memory power as over one's life, but not having other areas of cognition involved, and the severity of the memory problem is so mild that the person can still function independently.

That means can still pay bills, drive car safely, do grocery shopping. At one point, the same Mayo researchers believed 20 per cent of patients with MCI to advance to Alzheimer's disease in the following year, so there is a relationship. But some patients with MCI have recently had medical issues that clear along with the memory problem, or episodes of mood disorder that can be treated and resolved along with the memory problem.

Given that not all MCI is or will be Alzheimer's disease, it is still noteworthy that Pankratz et al. were able to not only confirm that sex itself is a complicated risk factor for MCI, and what complicates this are sex-differentiated risk factors that add in with a person's sex to influence that risk. Please do see the original article for details, but to summarize, women with all the additional risk factors specific to their sex have twice the risk of getting MCI over approximately five years than women without those risk factors.

The good news for us women is that one of those risk factors is reversible: older women should quit smoking if they haven't already. The other three, importantly for those of us between 35 and 65, were MID-LIFE high cholesterol, diabetes, and high blood pressure. You will recognize these as risk factors for heart attack as well. This report underscores the late-life effects of mid-life health problems, and the fascinating aspect of this, with regard to sex differences, is that these mid-life risk factors did not apply to men.,

In fact, men did not get off "easy," but their additional risk factors for MCI applied to their late lives (after age 70 years), not mid-life. Those two risk factors for men were: body mass index over 30 kg/metre-squared and never having been in a long-term, married relationship. It is not clear whether not married but living together partnerships were included in marriages above. Men with both risk factors TRIPLED their risk of developing MCI over the same period of time that the women were observed.

Women, this is your wake up call. Don't let stress during parenting, career-building, nesting, and maintaining your relationships become your downfall. I've said that before, but now there's more evidence to motivate good brain health behavior now, not later. And teach your daughters your good habits while you're at it!

Men, anxiety and depression arose as additional risk factors for you in a second model developed by the authors of the paper. Are those mood disorders causally related to not having a household partner? Unclear at this time, but do try to address anxiety and depression by remaining involved with your community, whether that includes family or friends, physical and mental activity.


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