Men who experience behaviour changes including apathy or having false beliefs and perceptions in later life are at risk of faster cognitive decline than women, according to new research.

The study, published in the Journal of Alzheimer’s Disease, was led by Charles University, in collaboration with the University of Exeter and King’s College London.

It aimed to explore gender/sex differences in the association of mild behavioral impairment (MBI) with the level of cognitive performance and its rate of decline in a dementia-free cohort.

MBI encompasses symptoms across five domains: apathy or social withdrawal; changes in mood and anxiety; being more impulsive than usual; being socially inappropriate; and having false beliefs or hallucinations. 

The researchers found that men who exhibit MBI symptoms are at risk of faster cognitive decline compared to women, particularly when psychotic symptoms or symptoms of decreased motivation occur.

Dr Katrin Wolfová, PhD student at Charles University in Prague, is first author of the study. She said: “Observing change in certain behavioural traits can help us to identify people who might already have a neurodegenerative disease before their cognitive functions decline. Being aware of differences between men and women in risk of developing dementia based on these behaviours is important for clinicians as well as researchers.”

Monitoring these symptoms could identify people earlier

Previous research suggests that possible explanations of these findings might be related to structural differences in entorhinal and hippocampal regions of brain, functional differences in serotonergic system, or unequal distribution of types of dementia in men and women.

The research team, which also involved collaborators from Canada, studied more than 8,000 people enrolled in the British online cohort (PROTECT) study, led by the University of Exeter and King’s College London. The participants were on average 63 years old and 73 per cent of them were women.

To assess cognitive functions, participants completed a series of online tests.  Behavioural changes, or MBI, were also assessed online via a specialised questionnaire in the PROTECT platform.

Dr Byron Creese, of the University of Exeter, said: “This research adds to the growing evidence that some people who experience suspicious thoughts or become withdrawn in later life have more memory and thinking problems. The findings are important because they suggest that monitoring these symptoms could help identify people with memory problems early on. The research also highlights the importance of gender differences in these relationships.”