Sex differences and Modifiable Dementia Risk Factors Synergistically Influence Memory over the Adult Lifespan

INTRODUCTION: More women than men develop Alzheimer’s disease, yet women show less age-related episodic memory decline, a contradiction that may be accounted for by modifiable risk factors for dementia. METHODS: Associations between sex, modifiable dementia risk factors, and cognition were measured in a cross-sectional online sample (n = 21,840, ages 18-89). RESULTS: Across four tests of associative memory and executive functions, only a Face-Name Association task revealed sex differences in age-related decline. Men had worse associative memory than women (the equivalent of four years of aging). Each additional risk factor had the equivalent of three and a half years of aging. Men had greater age-related decline in associative memory than women among those with no to one risk factors, but multiple risk factors eliminated the female advantage. DISCUSSION: Because the relationship between dementia risk factors and age-related memory decline differs for men and women, sex-specific dementia prevention approaches are warranted.