Objectives Previous studies on sex differences in cognitive decline provide inconsistent findings, with many European countries being underrepresented. We determined the association between sex and cognitive decline in a sample of Europeans and explored differences across birth cohorts and regions. Methods Participants 50+ years old enrolled in the Survey of Health, Ageing and Retirement in Europe had their cognition measured by tests of immediate recall, delayed recall and verbal fluency biennially up to 17 years of follow-up (median 6, interquartile range 3–9 years). We used linear mixed-effects models to assess the relationship between sex and the rate of cognitive decline, adjusting for sociodemographic and health-related characteristics. Results Of 66,670 participants (mean baseline age 63.5 ± standard deviation 9.4), 55% were female. Males and females had similar rates of decline in the whole sample in immediate recall (beta for interaction sex × time B = 0.002, 95% CI -0.001 to 0.006), delayed recall (B = 0.000, 95% CI −0.004 to 0.004), and verbal fluency (B = 0.008, 95% CI −0.005 to 0.020). Females born before World War II had a faster rate of decline in immediate recall and delayed recall compared to males, while females born during or after World War II had a slower rate of decline in immediate recall. Females in Central and Eastern Europe had a slower rate of cognitive decline in delayed recall compared to males. Discussion Our study does not provide strong evidence of sex differences in cognitive decline among older Europeans. However, we identified heterogeneity across birth cohorts and regions.

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中老年人认知能力下降的性别差异：欧洲的一项队列研究

目标 先前关于认知能力下降的性别差异的研究提供了不一致的结果，许多欧洲国家的代表性不足。我们确定了欧洲人样本中性别与认知能力下降之间的关联，并探讨了出生队列和地区之间的差异。方法 参加欧洲健康、老龄化和退休调查的 50 岁以上参与者，每两年通过即时回忆、延迟回忆和语言流畅性测试来测量他们的认知能力，随访时间长达 17 年（中位数 6，四分位数间距 3- 9 年）。我们使用线性混合效应模型来评估性别与认知能力下降率之间的关系，并根据社会人口统计和健康相关特征进行调整。结果 66,670 名参与者（平均基线年龄 63.5 ± 标准差 9.4）中，55% 为女性。在整个样本中，男性和女性在立即回忆（交互性别贝塔 × 时间 B = 0.002，95% CI -0.001 至 0.006）和延迟回忆（B = 0.000，95% CI -0.004 至 0.004）方面具有相似的下降率。和言语流畅性（B = 0.008，95% CI -0.005 至 0.020）。与男性相比，二战前出生的女性即时回忆和延迟回忆下降速度更快，而二战期间或之后出生的女性即时回忆下降速度较慢。与男性相比，中欧和东欧女性延迟回忆认知能力下降的速度较慢。讨论 我们的研究没有提供强有力的证据证明欧洲老年人认知能力下降存在性别差异。然而，我们发现出生队列和地区之间存在异质性。