Gender differences in cognitive reserve: An impact on progression in subjective cognitive decline?

This study investigated gender differences in cognitive reserve (CR) in subjective cognitive decline (SCD) and examined the impact of gender-CR interaction on the risk of progression to mild cognitive impairment (MCI).

We enrolled 440 SCD patients and estimated CR using premorbid intelligence (Test di Intelligenza Breve [TIB]). To account for socio-cultural differences, patients were stratified by birth cohort (pre-/post-1950). A Markov random-field (MRF) model explored relationships between gender, CR, education, and age. Logistic regression assessed MCI progression risk.

Women showed lower TIB scores than men (p < 0.001). The MRF model revealed an inverse connection between TIB and female gender, while no link was observed between TIB and generation. Progression to MCI was predicted by age at onset (p < 0.001), apolipoprotein E (APOE) status (p = 0.002), and TIB (p = 0.018), but not gender.

Gender has an impact on CR, but not through socio-economic variables. In turn, CR influenced the risk of MCI progression, whereas gender did not.

Subjective cognitive decline (SCD) women presented lower cognitive reserve (CR) levels than men, despite similar education levels.Social-cultural factors did not explain these gender differences in CR in SCD.The gender-CR interaction was not mediated by social-cultural factors.The risk of progression to mild cognitive impairment (MCI) was influenced by CR but not by gender.