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Published in: BMC Geriatrics 1/2021

01-12-2021 | Dementia | Research article

Decomposition of gender differences in cognitive functioning: National Survey of the Japanese elderly

Authors: Shohei Okamoto, Erika Kobayashi, Hiroshi Murayama, Jersey Liang, Taro Fukaya, Shoji Shinkai

Published in: BMC Geriatrics | Issue 1/2021

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Abstract

Background

It is well known that females generally live longer than males, but women tend to suffer from more illnesses and limitations than men do, also for dementia. However, limited empirical evidence is available why this ‘male-female health-survival paradox’ is observed. This study aimed to investigate factors which account for gender differences in health, particularly cognitive functioning and decline among older adults.

Methods

Data were retrieved from the National Survey of the Japanese Elderly, which is a longitudinal survey of a nationwide representative sample of Japanese adults aged 60 or over. Gender differences in cognitive functioning and decline in three-year follow-ups were decomposed using Blinder–Oaxaca decomposition analysis, regarding demographic, socioeconomic, and health-related factors into the ‘explained’ component, by differences in individual attributes listed above, and the ‘unexplained’ component.

Results

Empirical analyses showed that women’s lower cognitive functioning was partly explained by the endowment effect. Moreover, a shorter duration of formal education and a larger proportion with their longest occupation being domestic worker accounted for steeper cognitive decline and more prevalent mild cognitive impairment in women than in men.

Conclusion

This empirical study suggested that gender differences in cognitive functioning and decline account for different individual attributes of social determinants among men and women. Particularly, men seem to be more engaged in activities which accumulate intellectual experiences through education and occupation, as suggested by the cognitive reserve hypothesis.
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Literature
3.
go back to reference Asada T. Epidemiology of Dementia in Japan. In: Matsuda H, Asada T, Tokumaru AM, editors. Neuroimaging Diagnosis for Alzheimer’s Disease and Other Dementias. Tokyo: Springer Japan; 2017. p. 1–10. Asada T. Epidemiology of Dementia in Japan. In: Matsuda H, Asada T, Tokumaru AM, editors. Neuroimaging Diagnosis for Alzheimer’s Disease and Other Dementias. Tokyo: Springer Japan; 2017. p. 1–10.
4.
go back to reference Sado M, Ninomiya A, Shikimoto R, Ikeda B, Baba T, Yoshimura K, Mimura M. The estimated cost of dementia in Japan, the most aged society in the world. PLoS One. 2018;13(11):e0206508.PubMedPubMedCentralCrossRef Sado M, Ninomiya A, Shikimoto R, Ikeda B, Baba T, Yoshimura K, Mimura M. The estimated cost of dementia in Japan, the most aged society in the world. PLoS One. 2018;13(11):e0206508.PubMedPubMedCentralCrossRef
5.
go back to reference Livingston G, Huntley J, Sommerlad A, Ames D, Ballard C, Banerjee S, Brayne C, Burns A, Cohen-Mansfield J, Cooper C, et al. Dementia prevention, intervention, and care: 2020 report of the Lancet Commission. Lancet. 2020;396(10248):413–46.PubMedPubMedCentralCrossRef Livingston G, Huntley J, Sommerlad A, Ames D, Ballard C, Banerjee S, Brayne C, Burns A, Cohen-Mansfield J, Cooper C, et al. Dementia prevention, intervention, and care: 2020 report of the Lancet Commission. Lancet. 2020;396(10248):413–46.PubMedPubMedCentralCrossRef
8.
go back to reference Alzheimer Disease International. World Alzheimer Report 2015. In: The Global Impact of Dementia. An analysis of prevalence, incidence, cost and trends. London: Alzheimer Disease International; 2015. Alzheimer Disease International. World Alzheimer Report 2015. In: The Global Impact of Dementia. An analysis of prevalence, incidence, cost and trends. London: Alzheimer Disease International; 2015.
9.
go back to reference Laws KR, Irvine K, Gale TM. Sex differences in cognitive impairment in Alzheimer’s disease. World J Psychiatry. 2016;6(1):54–65. Laws KR, Irvine K, Gale TM. Sex differences in cognitive impairment in Alzheimer’s disease. World J Psychiatry. 2016;6(1):54–65.
11.
go back to reference Beam CR, Kaneshiro C, Jang JY, Reynolds CA, Pedersen NL, Gatz M. Differences Between Women and Men in Incidence Rates of Dementia and Alzheimer’s Disease. J Alzheimers Dis. 2018;64(4):1077–83.PubMedPubMedCentralCrossRef Beam CR, Kaneshiro C, Jang JY, Reynolds CA, Pedersen NL, Gatz M. Differences Between Women and Men in Incidence Rates of Dementia and Alzheimer’s Disease. J Alzheimers Dis. 2018;64(4):1077–83.PubMedPubMedCentralCrossRef
12.
go back to reference Andersen K, Launer LJ, Dewey ME, Letenneur L, Ott A, Copeland JRM, Dartigues JF, Kragh-Sorensen P, Baldereschi M, Brayne C, et al. Gender differences in the incidence of AD and vascular dementia: The EURODEM Studies. Neurology. 1999;53(9):1992.PubMedCrossRef Andersen K, Launer LJ, Dewey ME, Letenneur L, Ott A, Copeland JRM, Dartigues JF, Kragh-Sorensen P, Baldereschi M, Brayne C, et al. Gender differences in the incidence of AD and vascular dementia: The EURODEM Studies. Neurology. 1999;53(9):1992.PubMedCrossRef
13.
14.
go back to reference Rieker PP, Bird CE. Rethinking Gender Differences in Health: Why We Need to Integrate Social and Biological Perspectives. J Gerontol B Psychol Sci Soc Sci. 2005;60(Special_Issue_2):S40–7.CrossRef Rieker PP, Bird CE. Rethinking Gender Differences in Health: Why We Need to Integrate Social and Biological Perspectives. J Gerontol B Psychol Sci Soc Sci. 2005;60(Special_Issue_2):S40–7.CrossRef
15.
go back to reference Nebel RA, Aggarwal NT, Barnes LL, Gallagher A, Goldstein JM, Kantarci K, Mallampalli MP, Mormino EC, Scott L, Yu WH, et al. Understanding the impact of sex and gender in Alzheimer's disease: A call to action. Alzheimers Dement. 2018;14(9):1171–83.PubMedPubMedCentralCrossRef Nebel RA, Aggarwal NT, Barnes LL, Gallagher A, Goldstein JM, Kantarci K, Mallampalli MP, Mormino EC, Scott L, Yu WH, et al. Understanding the impact of sex and gender in Alzheimer's disease: A call to action. Alzheimers Dement. 2018;14(9):1171–83.PubMedPubMedCentralCrossRef
17.
go back to reference Vlassoff C. Gender differences in determinants and consequences of health and illness. J Health Popul Nutr. 2007;25(1):47–61.PubMedPubMedCentral Vlassoff C. Gender differences in determinants and consequences of health and illness. J Health Popul Nutr. 2007;25(1):47–61.PubMedPubMedCentral
18.
go back to reference Sen G, Ostlin P, George A. Unequal, Unfair, Ineffective and Inefficient. In: Gender inequity in health: why it exists and how we can change it—Final report of the Women and Gender Equity Knowledge Network (WGEKN). Geneva: World Health Organization; 2007. Sen G, Ostlin P, George A. Unequal, Unfair, Ineffective and Inefficient. In: Gender inequity in health: why it exists and how we can change it—Final report of the Women and Gender Equity Knowledge Network (WGEKN). Geneva: World Health Organization; 2007.
19.
go back to reference Kautzky-Willer A, Harreiter J, Pacini G. Sex and Gender Differences in Risk, Pathophysiology and Complications of Type 2 Diabetes Mellitus. Endocr Rev. 2016;37(3):278–316.PubMedPubMedCentralCrossRef Kautzky-Willer A, Harreiter J, Pacini G. Sex and Gender Differences in Risk, Pathophysiology and Complications of Type 2 Diabetes Mellitus. Endocr Rev. 2016;37(3):278–316.PubMedPubMedCentralCrossRef
21.
go back to reference Verbrugge LM. Gender and health: an update on hypotheses and evidence. J Health Soc Behav. 1985;26(3):156–82.PubMedCrossRef Verbrugge LM. Gender and health: an update on hypotheses and evidence. J Health Soc Behav. 1985;26(3):156–82.PubMedCrossRef
22.
go back to reference Moss NE. Gender equity and socioeconomic inequality: a framework for the patterning of women's health. Soc Sci Med. 2002;54(5):649–61.PubMedCrossRef Moss NE. Gender equity and socioeconomic inequality: a framework for the patterning of women's health. Soc Sci Med. 2002;54(5):649–61.PubMedCrossRef
23.
go back to reference Denton M, Prus S, Walters V. Gender differences in health: a Canadian study of the psychosocial, structural and behavioural determinants of health. Soc Sci Med. 2004;58(12):2585–600.PubMedCrossRef Denton M, Prus S, Walters V. Gender differences in health: a Canadian study of the psychosocial, structural and behavioural determinants of health. Soc Sci Med. 2004;58(12):2585–600.PubMedCrossRef
24.
go back to reference Podcasy JL, Epperson CN. Considering sex and gender in Alzheimer disease and other dementias. Dialogues Clin Neurosci. 2017;18(4):437–46. Podcasy JL, Epperson CN. Considering sex and gender in Alzheimer disease and other dementias. Dialogues Clin Neurosci. 2017;18(4):437–46.
25.
26.
go back to reference Newman AB, Fitzpatrick AL, Lopez O, Jackson S, Lyketsos C, Jagust W, Ives D, DeKosky ST, Kuller LH. Dementia and Alzheimer's Disease Incidence in Relationship to Cardiovascular Disease in the Cardiovascular Health Study Cohort. J Am Geriatr Soc. 2005;53(7):1101–7.PubMedCrossRef Newman AB, Fitzpatrick AL, Lopez O, Jackson S, Lyketsos C, Jagust W, Ives D, DeKosky ST, Kuller LH. Dementia and Alzheimer's Disease Incidence in Relationship to Cardiovascular Disease in the Cardiovascular Health Study Cohort. J Am Geriatr Soc. 2005;53(7):1101–7.PubMedCrossRef
27.
go back to reference Kim M-Y, Kim K, Hong CH, Lee SY, Jung Y-S. Sex Differences in Cardiovascular Risk Factors for Dementia. Biomol Ther. 2018;26(6):521–32.CrossRef Kim M-Y, Kim K, Hong CH, Lee SY, Jung Y-S. Sex Differences in Cardiovascular Risk Factors for Dementia. Biomol Ther. 2018;26(6):521–32.CrossRef
28.
go back to reference Anstey KJ, von Sanden C, Salim A, O'Kearney R. Smoking as a risk factor for dementia and cognitive decline: a meta-analysis of prospective studies. Am J Epidemiol. 2007;166(4):367–78.PubMedCrossRef Anstey KJ, von Sanden C, Salim A, O'Kearney R. Smoking as a risk factor for dementia and cognitive decline: a meta-analysis of prospective studies. Am J Epidemiol. 2007;166(4):367–78.PubMedCrossRef
29.
go back to reference Barberger-Gateau P, Raffaitin C, Letenneur L, Berr C, Tzourio C, Dartigues JF, Alperovitch A. Dietary patterns and risk of dementia: the Three-City cohort study. Neurology. 2007;69(20):1921–30.PubMedCrossRef Barberger-Gateau P, Raffaitin C, Letenneur L, Berr C, Tzourio C, Dartigues JF, Alperovitch A. Dietary patterns and risk of dementia: the Three-City cohort study. Neurology. 2007;69(20):1921–30.PubMedCrossRef
30.
go back to reference Sofi F, Valecchi D, Bacci D, Abbate R, Gensini GF, Casini A, Macchi C. Physical activity and risk of cognitive decline: a meta-analysis of prospective studies. J Intern Med. 2011;269(1):107–17.PubMedCrossRef Sofi F, Valecchi D, Bacci D, Abbate R, Gensini GF, Casini A, Macchi C. Physical activity and risk of cognitive decline: a meta-analysis of prospective studies. J Intern Med. 2011;269(1):107–17.PubMedCrossRef
31.
go back to reference Bilodeau J, Marchand A, Demers A. Psychological distress inequality between employed men and women: A gendered exposure model. SSM Population Health. 2020;11:100626. Bilodeau J, Marchand A, Demers A. Psychological distress inequality between employed men and women: A gendered exposure model. SSM Population Health. 2020;11:100626.
32.
go back to reference Taylor SE, Klein LC, Lewis BP, Gruenewald TL, Gurung RAR, Updegraff JA. Biobehavioral responses to stress in females: Tend-and-befriend, not fight-or-flight. Psychological Rev. 2000;107(3):411–29.CrossRef Taylor SE, Klein LC, Lewis BP, Gruenewald TL, Gurung RAR, Updegraff JA. Biobehavioral responses to stress in females: Tend-and-befriend, not fight-or-flight. Psychological Rev. 2000;107(3):411–29.CrossRef
33.
go back to reference Brannon L. Stress, Coping, and Psychopathology. In: Gender: psychological perspectives. 7th ed. New York: Taylor & Francis; 2017. p. 429–67. Brannon L. Stress, Coping, and Psychopathology. In: Gender: psychological perspectives. 7th ed. New York: Taylor & Francis; 2017. p. 429–67.
34.
go back to reference Adler NE, Newman K. Socioeconomic disparities in health: pathways and policies. Health Aff. 2002;21(2):60–76.CrossRef Adler NE, Newman K. Socioeconomic disparities in health: pathways and policies. Health Aff. 2002;21(2):60–76.CrossRef
35.
go back to reference Ben-Shlomo Y, Kuh D. A life course approach to chronic disease epidemiology: conceptual models, empirical challenges and interdisciplinary perspectives. Int J Epidemiol. 2002;31(2):285–93.PubMedCrossRef Ben-Shlomo Y, Kuh D. A life course approach to chronic disease epidemiology: conceptual models, empirical challenges and interdisciplinary perspectives. Int J Epidemiol. 2002;31(2):285–93.PubMedCrossRef
36.
go back to reference Hasselgren C, Ekbrand H, Halleröd B, Mellqvist Fässberg M, Zettergren A, Johansson L, Skoog I, Dellve L. Sex differences in dementia: on the potentially mediating effects of educational attainment and experiences of psychological distress. BMC Psychiatry. 2020;20(1):434. Hasselgren C, Ekbrand H, Halleröd B, Mellqvist Fässberg M, Zettergren A, Johansson L, Skoog I, Dellve L. Sex differences in dementia: on the potentially mediating effects of educational attainment and experiences of psychological distress. BMC Psychiatry. 2020;20(1):434.
37.
go back to reference Stern Y. What is cognitive reserve? Theory and research application of the reserve concept. J Int Neuropsychol Soc. 2002;8(03):448–60.PubMedCrossRef Stern Y. What is cognitive reserve? Theory and research application of the reserve concept. J Int Neuropsychol Soc. 2002;8(03):448–60.PubMedCrossRef
38.
go back to reference Meng X, D'Arcy C. Education and dementia in the context of the cognitive reserve hypothesis: a systematic review with meta-analyses and qualitative analyses. PLoS One. 2012;7(6):e38268.PubMedPubMedCentralCrossRef Meng X, D'Arcy C. Education and dementia in the context of the cognitive reserve hypothesis: a systematic review with meta-analyses and qualitative analyses. PLoS One. 2012;7(6):e38268.PubMedPubMedCentralCrossRef
39.
go back to reference Okamoto S. Socioeconomic factors and the risk of cognitive decline among the elderly population in Japan. Int J Geriatr Psychiatry. 2019;34(2):265–71.PubMedCrossRef Okamoto S. Socioeconomic factors and the risk of cognitive decline among the elderly population in Japan. Int J Geriatr Psychiatry. 2019;34(2):265–71.PubMedCrossRef
40.
go back to reference Hammig O, Gutzwiller F, Kawachi I. The contribution of lifestyle and work factors to social inequalities in self-rated health among the employed population in Switzerland. Soc Sci Med. 2014;121:74–84.PubMedCrossRef Hammig O, Gutzwiller F, Kawachi I. The contribution of lifestyle and work factors to social inequalities in self-rated health among the employed population in Switzerland. Soc Sci Med. 2014;121:74–84.PubMedCrossRef
41.
go back to reference Rogers RG, Everett BG, Onge JM, Krueger PM. Social, behavioral, and biological factors, and sex differences in mortality. Demography. 2010;47(3):555–78.PubMedPubMedCentralCrossRef Rogers RG, Everett BG, Onge JM, Krueger PM. Social, behavioral, and biological factors, and sex differences in mortality. Demography. 2010;47(3):555–78.PubMedPubMedCentralCrossRef
42.
go back to reference Kavanagh A, Bentley RJ, Turrell G, Shaw J, Dunstan D, Subramanian SV. Socioeconomic position, gender, health behaviours and biomarkers of cardiovascular disease and diabetes. Soc Sci Med. 2010;71(6):1150–60.PubMedCrossRef Kavanagh A, Bentley RJ, Turrell G, Shaw J, Dunstan D, Subramanian SV. Socioeconomic position, gender, health behaviours and biomarkers of cardiovascular disease and diabetes. Soc Sci Med. 2010;71(6):1150–60.PubMedCrossRef
43.
go back to reference Cherepanov D, Palta M, Fryback DG, Robert SA. Gender differences in health-related quality-of-life are partly explained by sociodemographic and socioeconomic variation between adult men and women in the US: evidence from four US nationally representative data sets. Qual Life Res. 2010;19(8):1115–24.PubMedPubMedCentralCrossRef Cherepanov D, Palta M, Fryback DG, Robert SA. Gender differences in health-related quality-of-life are partly explained by sociodemographic and socioeconomic variation between adult men and women in the US: evidence from four US nationally representative data sets. Qual Life Res. 2010;19(8):1115–24.PubMedPubMedCentralCrossRef
44.
go back to reference Zunzunegui MV, Alvarado BE, Beland F, Vissandjee B. Explaining health differences between men and women in later life: a cross-city comparison in Latin America and the Caribbean. Soc Sci Med. 2009;68(2):235–42.PubMedCrossRef Zunzunegui MV, Alvarado BE, Beland F, Vissandjee B. Explaining health differences between men and women in later life: a cross-city comparison in Latin America and the Caribbean. Soc Sci Med. 2009;68(2):235–42.PubMedCrossRef
45.
go back to reference Zhou Z, Wang P, Fang Y. Loneliness and the risk of dementia among older Chinese adults: gender differences. Aging Ment Health. 2017;22(4):519–25.PubMedCrossRef Zhou Z, Wang P, Fang Y. Loneliness and the risk of dementia among older Chinese adults: gender differences. Aging Ment Health. 2017;22(4):519–25.PubMedCrossRef
46.
go back to reference Jann B. The Blinder-Oaxaca decomposition for linear regression models. Stata J. 2008;8(4):453–79.CrossRef Jann B. The Blinder-Oaxaca decomposition for linear regression models. Stata J. 2008;8(4):453–79.CrossRef
47.
go back to reference Pfeiffer E. A short portable mental status questionnaire for the assessment of organic brain deficit in elderly patients. J Am Geriatr Soc. 1975;23(10):433–41.PubMedCrossRef Pfeiffer E. A short portable mental status questionnaire for the assessment of organic brain deficit in elderly patients. J Am Geriatr Soc. 1975;23(10):433–41.PubMedCrossRef
48.
go back to reference Liang J, Borawski-Clark E, Liu X, Sugisawa H. Transitions in cognitive status among the aged in Japan. Soc Sci Med. 1996;43(3):325–37.PubMedCrossRef Liang J, Borawski-Clark E, Liu X, Sugisawa H. Transitions in cognitive status among the aged in Japan. Soc Sci Med. 1996;43(3):325–37.PubMedCrossRef
49.
go back to reference van Gelder BM, Tijhuis M, Kalmijn S, Giampaoli S, Nissinen A, Kromhout D. Marital status and living situation during a 5-year period are associated with a subsequent 10-year cognitive decline in older men: the FINE Study. J Gerontol B Psychol Sci Soc Sci. 2006;61(4):P213–9.PubMedCrossRef van Gelder BM, Tijhuis M, Kalmijn S, Giampaoli S, Nissinen A, Kromhout D. Marital status and living situation during a 5-year period are associated with a subsequent 10-year cognitive decline in older men: the FINE Study. J Gerontol B Psychol Sci Soc Sci. 2006;61(4):P213–9.PubMedCrossRef
52.
go back to reference Lin FR, Metter EJ, O’Brien RJ, Resnick SM, Zonderman AB, Ferrucci L. Hearing Loss and Incident Dementia. Arch Neurol. 2011;68(2):214–20. Lin FR, Metter EJ, O’Brien RJ, Resnick SM, Zonderman AB, Ferrucci L. Hearing Loss and Incident Dementia. Arch Neurol. 2011;68(2):214–20.
53.
go back to reference Fine JP, Gray RJ. A Proportional Hazards Model for the Subdistribution of a Competing Risk. J Amer Stat Assoc. 1999;94(446):496–509.CrossRef Fine JP, Gray RJ. A Proportional Hazards Model for the Subdistribution of a Competing Risk. J Amer Stat Assoc. 1999;94(446):496–509.CrossRef
54.
go back to reference Heitmueller A. A Note on Decompositions in Fixed Effects Models in the Presence of Time-Invariant Characteristics. In: IZA Discussion Papers, vol. 1886. Bonn: Institute of Labor Economics (IZA); 2005. Heitmueller A. A Note on Decompositions in Fixed Effects Models in the Presence of Time-Invariant Characteristics. In: IZA Discussion Papers, vol. 1886. Bonn: Institute of Labor Economics (IZA); 2005.
55.
go back to reference Powers DA, Yun M-S. Multivariate Decomposition for Hazard Rate Models. Sociol Methodol. 2009;39(1):233–63.CrossRef Powers DA, Yun M-S. Multivariate Decomposition for Hazard Rate Models. Sociol Methodol. 2009;39(1):233–63.CrossRef
56.
go back to reference Li S-C, Lindenberger U, Sikström S. Aging cognition: from neuromodulation to representation. Trends Cogn Sci. 2001;5(11):479–86.PubMedCrossRef Li S-C, Lindenberger U, Sikström S. Aging cognition: from neuromodulation to representation. Trends Cogn Sci. 2001;5(11):479–86.PubMedCrossRef
57.
go back to reference Oaxaca R. Male-Female Wage Differentials in Urban Labor Markets. Int Econ Rev. 1973;14(3):693–709. Oaxaca R. Male-Female Wage Differentials in Urban Labor Markets. Int Econ Rev. 1973;14(3):693–709.
58.
go back to reference Blinder AS. Wage Discrimination: Reduced Form and Structural Estimates. J Hum Res. 1973;8(4):436–55. Blinder AS. Wage Discrimination: Reduced Form and Structural Estimates. J Hum Res. 1973;8(4):436–55.
59.
go back to reference Saito Y. Gender Equality in Education: Japanese Experience. NIER Res Bull. 2014;143:137–49. Saito Y. Gender Equality in Education: Japanese Experience. NIER Res Bull. 2014;143:137–49.
61.
go back to reference Gender Equality Bureau Cabinet Office: White paper on gender equality 2019. 2019, (in Japanese). Gender Equality Bureau Cabinet Office: White paper on gender equality 2019. 2019, (in Japanese).
62.
go back to reference Palencia L, Malmusi D, De Moortel D, Artazcoz L, Backhans M, Vanroelen C, Borrell C. The influence of gender equality policies on gender inequalities in health in Europe. Soc Sci Med. 2014;117:25–33.PubMedCrossRef Palencia L, Malmusi D, De Moortel D, Artazcoz L, Backhans M, Vanroelen C, Borrell C. The influence of gender equality policies on gender inequalities in health in Europe. Soc Sci Med. 2014;117:25–33.PubMedCrossRef
63.
go back to reference Borrell C, Palencia L, Muntaner C, Urquia M, Malmusi D, O'Campo P. Influence of Macrosocial Policies on Women's Health and Gender Inequalities in Health. Epidemiol Rev. 2013;36(1):31–48.PubMedCrossRef Borrell C, Palencia L, Muntaner C, Urquia M, Malmusi D, O'Campo P. Influence of Macrosocial Policies on Women's Health and Gender Inequalities in Health. Epidemiol Rev. 2013;36(1):31–48.PubMedCrossRef
64.
go back to reference Roehr S, Pabst A, Luck T, Riedel-Heller SG. Is dementia incidence declining in high-income countries? A systematic review and meta-analysis. Clin Epidemiol. 2018;10:1233–47.PubMedPubMedCentralCrossRef Roehr S, Pabst A, Luck T, Riedel-Heller SG. Is dementia incidence declining in high-income countries? A systematic review and meta-analysis. Clin Epidemiol. 2018;10:1233–47.PubMedPubMedCentralCrossRef
65.
go back to reference Kobayashi E, Liang J. Age and Cohort Differences in Social Networks among Older Adults. Japan Sociol Rev. 2011;62(3):356–74.CrossRef Kobayashi E, Liang J. Age and Cohort Differences in Social Networks among Older Adults. Japan Sociol Rev. 2011;62(3):356–74.CrossRef
66.
go back to reference Erkinjuntti T, Sulkava R, Wikström J, Autio L. Short Portable Mental Status Questionnaire as a Screening Test for Dementia and Delirium Among the Elderly. J Am Geriatr Soc. 1987;35(5):412–6.PubMedCrossRef Erkinjuntti T, Sulkava R, Wikström J, Autio L. Short Portable Mental Status Questionnaire as a Screening Test for Dementia and Delirium Among the Elderly. J Am Geriatr Soc. 1987;35(5):412–6.PubMedCrossRef
67.
go back to reference Miyamoto M, Kodama C, Kinoshita T, Yamashita F, Hidaka S, Mizukami K, Kakuma T, Asada T. Dementia and mild cognitive impairment among non-responders to a community survey. J Clin Neurosci. 2009;16(2):270–6.PubMedCrossRef Miyamoto M, Kodama C, Kinoshita T, Yamashita F, Hidaka S, Mizukami K, Kakuma T, Asada T. Dementia and mild cognitive impairment among non-responders to a community survey. J Clin Neurosci. 2009;16(2):270–6.PubMedCrossRef
68.
go back to reference Amjad H, Roth DL, Sheehan OC, Lyketsos CG, Wolff JL, Samus QM. Underdiagnosis of Dementia: an Observational Study of Patterns in Diagnosis and Awareness in US Older Adults. J Gen Intern Med. 2018;33(7):1131–8.PubMedPubMedCentralCrossRef Amjad H, Roth DL, Sheehan OC, Lyketsos CG, Wolff JL, Samus QM. Underdiagnosis of Dementia: an Observational Study of Patterns in Diagnosis and Awareness in US Older Adults. J Gen Intern Med. 2018;33(7):1131–8.PubMedPubMedCentralCrossRef
Metadata
Title
Decomposition of gender differences in cognitive functioning: National Survey of the Japanese elderly
Authors
Shohei Okamoto
Erika Kobayashi
Hiroshi Murayama
Jersey Liang
Taro Fukaya
Shoji Shinkai
Publication date
01-12-2021
Publisher
BioMed Central
Keywords
Dementia
Dementia
Published in
BMC Geriatrics / Issue 1/2021
Electronic ISSN: 1471-2318
DOI
https://doi.org/10.1186/s12877-020-01990-1

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