The Influence of Sex Differences on Educational Attainment and Occupational Complexity: Characterizing Cognitive Reserve and Cognitive Decline

Abstract

Background: Cognitive reserve (CR) has been associated with better cognitive function and lower risk of dementia in older people, yet it remains unclear whether sex moderates the association between CR and cognition. This study aims to identify whether sex influences both the relationships between brain-cognition and how CR proxies moderate the brain-cognition relationship. Materials and Methods: Complete data on the measures of CR, education, occupation, and cognition were available for 189 healthy individuals aged 60 to 71 years (105 men and 84 women). Multiple linear regression models were used to investigate the potential effect of sex and CR proxies on the association between the brain and cognition measures. Results: The results highlighted differences in speed/attention for males compared to females at high education and high occupational complexity. No significant sex differences in brain measures were observed in meanPutamen, meanCaudate, and meanHippocampal volume. Conclusion/Significance: Traditional reserve contributors are influenced by gender and may be a result of different social determinants among men and women. Both sex-specific risk and protective factors for cognitive decline trajectories are critical for advancing knowledge for individualized interventions.