Introduction: Past research suggested that early- and late-life cognitive activities may contribute to cognitive resilience (CR) differently between genders. This study examined gender differences in the association between different CR proxies and mild cognitive impairment (MCI) incidence in an Australian population-based cohort.

Methods: 1806 participants who had completed at least the first two waves and up to four waves of assessments (12 years of follow-up) in the Personality and Total Health (PATH) through life study (Baseline: 49% Female, Mage=62.5, SD=1.5) were included. CR proxies included measures of education, occupation skill, verbal intelligence, and leisure activity. Discrete-time survival analyses were conducted to examine gender differences in the association between CR proxies and clinical diagnosis of MCI, adjusting for age and Apolipoprotein E4 status.

Results: Lower occupation skill was more strongly associated with higher risk in men than in women (OR = 1.30, 95% CI[1.07, 1.57]). In both genders, after adjusting for education and occupation, one SD increase in leisure activity was associated with lower MCI risk by 32% (OR = 0.76, 95% CI[0.65, 0.89]). Higher scores in verbal intelligence were associated with reduced risk of MCI by 28% (OR = 0.78, 95% CI[0.69, 0.89]). The association between education and CR was attenuated after verbal intelligence and leisure activity were considered.

Conclusion: Occupational experience may contribute to cognitive resilience differently between genders, while late-life leisure activity was strongly associated with lower MCI risk. Further research on the impact of gendered occupations and leisure activity may better explain gender differences in cognitive resilience.