Sex Differences in Cortical Morphometry during Ageing: Examining the Interplay between Lifestyle and Reproductive Factors

Sex differences in neurodegenerative disorder prevalence have been attributed to life expectancy, modifiable risk factors related to lifestyle and the impact of changes in sex hormones and the reproductive system. Although these factors are known to interact with one another, they are often studied in isolation. Here, we used a multivariate approach to investigate how lifestyle, along with menopause and the number of children, interacts with cortical thickness (CT) in healthy adults. Using CT measures from T1-weighted scans (MPRAGE, 1 mm3 voxels; 124 participants; 67 females; 40-70 years old) from the Cam-CAN dataset. Using a partial least squares decomposition, we identified patterns of covariance between CT and lifestyle factors, menopause and the number of children. In women, we identified significant patterns that linked education, socioeconomic status, social contact and length of reproductive period to CT in the left prefrontal cortex, as well as alcohol consumption, physical activity and menopausal status to CT in the frontal poles. Contrastingly, the results in men were driven by education and anxiety, and involved increased CT in the temporal poles. Our findings suggests that sex differences in cortical anatomy during brain ageing might be driven by interactions between contrasting lifestyles and the female-specific endocrine environment.