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Adults with cerebral palsy (CP) have higher risk of developing geriatric syndromes. Mild cognitive impairment (MCI) is an intermediate stage between healthy aging and dementia, often co-morbid with cardiovascular disease (CVD). We recently showed an “accelerated aging model”, where CP shares similar CVD risk factors with MCI, potentially accounting for CP's increased risk of dementia. In this study, we further examined sex differences between CP and MCI (aim 1) and within CP (aim 2).
An accredited clinical motion analysis laboratory at Children's Hospital Colorado (CP) and a university in Singapore (MCI).
72 adults with CP [mean (SD) of age=20 (5.3), Sex: men=47.2% and women=52.8%] and MCI [mean (SD) of age=71.28 (6.03), Sex: men=29.2% and women=70.8%]. We analyzed blood Pressure (BP), Framingham Heart Study Score (FHSS), and brain-derived neurotrophic factor (BDNF).
Main Outcome Measures
Blood Pressure (Bp), Framingham Heart Study Score (FHSS), and brain-derived neurotrophic factor (BDNF) biomarker analyses were conducted. To address aim 1; BDNF and the FHSS were compared between CP and MCI using regression analyses, stratified by sex. For aim 2, regression analyses were performed to compare men and women outcomes within CP. Confounding effects of age and years of education were controlled in the analysis.
Compared to MCI, women with CP had lower BDNF (β=-3.550, 95% CI=-5.659 to -1.441, p=0.001), while men with CP had lower diastolic Bp (β=-28.204, 95% CI=-52.148 to -4.260, p=0.022). Both women and men with CP also had lower FHSS as compared to MCI (β=-2.515, 95% CI=-3.721 to -1.309, p<0.001; β=-3.724, 95% CI=-5.561 to -1.888, p<0.001, respectively). Women in the CP cohort showed lower FHSS (β=-0.172, 95% CI=-0.310 to -0.033, p=0.016).
We found sex-related differences in BDNF and CVD markers. Comparing across and within cohorts, although having lower BDNF levels, women with CP had better FHSS. These findings support our accelerated aging hypothesis, and further suggest sex differences in aging-related risk factors in CP, supporting sex-related precision medicine approach.
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