{
  "abstract": "Background\n\nEvidence on sex differences in cognition and dementia is inconsistent, and it is unclear whether such differences are explained by dementia risk factors.Objective\n\nTo assess (i) sex differences in cognitive decline and dementia risk, (ii) the extent to which modifiable and nonmodifiable risk factors explain these differences and (iii) whether birth cohort and apolipoprotein (APOE)-Ꜫ4 carrier status modify sex differences in cognitive decline.Methods\n\nData from the Whitehall II study were analysed to examine cross-sectional and longitudinal associations between sex, cognitive decline and dementia risk. Cognitive outcomes included verbal memory and verbal fluency, assessed from Phase 5 onward, with over 16 years of follow-up. Test scores were standardised using means and standard deviations from the baseline cognitive tests to generate z-scores. All-cause dementia was ascertained through linkage to three electronic health record databases.Results\n\nAmong 5920 participants aged 44.8-68.2 years, women demonstrated better baseline performance than men in memory (adjusted mean difference = -0.2, p < 0.0001), phonemic fluency (-0.1, p = 0.001) and semantic fluency (-0.2, p < 0.0001). Men exhibited a steeper decline in semantic fluency (adjusted β = -2.6, p < 0.0001) and a nominal decline in phonemic fluency (-1.7, p = 0.007). Sex differences remained after adjustment for covariates. Dementia incidence did not differ significantly by sex. Birth cohort and APOE-Ꜫ4 carrier status did not meaningfully modify associations between sex and cognitive outcomes.Conclusion\n\nCognitive advantages observed in women in midlife did not translate into lower dementia risk. Further research incorporating biological, psychosocial and life-course factors, as well as the timing and heterogeneity of underlying disease processes, is needed to better understand sex differences in cognitive ageing and dementia.",
  "abstract_shown": true,
  "affiliations": [
    "Ageing Epidemiology (AGE) Research Unit School of Public Health Imperial College London London UK imperial.ac.uk.",
    "Surgery and Cancer Imperial College London London UK imperial.ac.uk.",
    "Division of Clinical Geriatrics Center for Alzheimer Research Karolinska Institutet and Karolinska University Hospital Stockholm Sweden ki.se.",
    "Imperial Clinical Trials Unit School of Public Health Imperial College London London UK imperial.ac.uk.",
    "Department of Epidemiology and Biostatistics MRC Centre for Environment and Health School of Public Health, Imperial College London London UK."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 4,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "Sima Toopchiani",
      "orcid": "0009-0003-9271-144X"
    },
    {
      "affs": [
        0,
        2
      ],
      "name": "Shireen Sindi",
      "orcid": "0000-0002-3786-0552"
    },
    {
      "affs": [
        3
      ],
      "name": "Leila Janani",
      "orcid": "0000-0003-3829-6364"
    },
    {
      "affs": [
        0,
        4
      ],
      "name": "Oliver Robinson",
      "orcid": "0000-0002-4735-0468"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/0kv6d3nmqe2aj.bib",
  "cited_by": 0,
  "doi": "10.1155/jare/1953393",
  "fulltext_url": "https://europepmc.org/articles/PMC13717236",
  "id": "0kv6d3nmqe2aj",
  "issns": [
    "2090-2204",
    "2090-2212"
  ],
  "landing_url": "https://europepmc.org/article/MED/42959399",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Article"
    ],
    [
      "heading",
      "Research Article"
    ],
    [
      "openalex",
      "2738|Dementia and Cognitive Impairment Research"
    ]
  ],
  "openalex": "W7224544542",
  "pdf_url": "https://europepmc.org/articles/PMC13717236?pdf=render",
  "pmcid": "PMC13717236",
  "pmid": "42959399",
  "published": "2026-10-28",
  "publisher": "Wiley",
  "ris": "https://research.draconitic.com/paper/0kv6d3nmqe2aj.ris",
  "sources": [
    {
      "first_seen": "2026-11-01T00:20:50Z",
      "native_id": "MED:42959399",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42959399"
    },
    {
      "first_seen": "2026-11-02T12:21:35Z",
      "native_id": "PMC13717236",
      "source": "pmc",
      "url": "https://doi.org/10.1155/jare/1953393"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2738|Dementia and Cognitive Impairment Research",
      "subfield": "psychiatry"
    }
  ],
  "title": "Sex Differences in Domain-Specific Cognitive Trajectories and Dementia Risk: Evidence From the Whitehall II Cohort.",
  "title_text": "Sex Differences in Domain-Specific Cognitive Trajectories and Dementia Risk: Evidence From the Whitehall II Cohort.",
  "type": "peer-reviewed",
  "updated_at": "2026-11-02T12:21:35Z",
  "url": "https://research.draconitic.com/paper/0kv6d3nmqe2aj",
  "venue": "Journal of aging research",
  "versions": []
}