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The significance of hormone action in psychiatry has been long studied, now including the psychiatric effects of hormones on the aging process. This clinical reference addresses the hormonal basis of mental disorders in older people. Hormones influence a wide range of states and conditions, from pain tolerance and anorexia to attention, mood, immunity, cardiovascular and cognitive function, schizophrenia and Alzheimer's disease. Written by an eminent team of psychiatrists, psychologists, geriatricians and neuropharmacologists, this book brings together established information and findings in four sections: • An overview of the basic science of neurosteroids • Sex difference and the roles that cortisol, thyroid hormone, and the sex steroids estrogen, progesterone, dehydroepiandrosterone and testosterone play in common mental disorders and pain sensitivity • Psychoneuroimmunology in relation to age • Sex differences and hormones in psychotropic drug metabolism in the elderly.

Local alterations in vasodilator responsiveness may significantly influence the leg hyperemic response to dynamic exercise in aging humans in a sex-specific manner. This series of dissertation studies was designed to examine local alterations in leg vasodilatory responsiveness with age in women, directly test the hypothesis that older women exhibit greater reductions in leg exercise hyperemia than men during exercise not limited by central mechanisms, and examine the consequences for observed alterations in leg vasodilation during exercise in older women. The purpose of the first study was to compare age differences in brachial and popliteal flow-mediated dilation (FMD) and shear rate in women. Findings suggest that FMD is lower with age in women in both limbs, perhaps due to reductions in smooth muscle responsiveness. The purpose of the second study was to test the hypothesis that metabolic inhibition of a sympathetic stimulus (i.e., sympatholysis) is reduced with age in the lower extremity vasculature of women. Findings suggest that older women exhibit diminished popliteal artery reactivity and reduced sympatholysis in the leg resistance vasculature. The purpose of the third study was to test hypothesis that exercise-induced vasodilator responses are greater in young women than men. Findings suggest that the vasodilatory response to dynamic leg exercise is greater in young women vs. men. The purpose of the fourth study was to test the hypothesis that age by sex interactions in exercising leg hemodynamics persist during small muscle mass exercise that is not limited by cardiac output. Findings suggest that local (non-cardiac) factors underlie the blunted leg vasodilation observed in older women but not older men. The purpose of the fifth study was to test the hypothesis that active muscle oxygen extraction would be higher in older women during knee extensor exercise. Findings suggest that older women do not compensate for blunted whole limb hyperemia through an augmentation of local oxygen extraction. These studies provide evidence for alterations in local vasodilator control and blunted leg vasodilation during exercise in older women, which may affect exercise capacity and blood pressure regulation.

Aging is a complex biological process characterized by hallmark features accumulating over the life course, shaping the individual's aging trajectory and subsequent disease risks. There is substantial individual variability in the aging process between men and women. In general, women live longer than men, consistent with lower biological ages as assessed by molecular biomarkers, but there is a paradox. Women are frailer and have worse health at the end of life, while men still perform better in physical function examinations. Moreover, many age-related diseases show sex-specific patterns. In this review, we aim to summarize the current knowledge on sexual dimorphism in human studies, with support from animal research, on biological aging and illnesses. We also attempt to place it in the context of the theories of aging, as well as discuss the explanations for the sex differences, for example, the sex-chromosome linked mechanisms and hormonally driven differences.

Sex differences influence brain morphology and physiology during both development and aging. Here we apply a machine learning algorithm to a multiparametric brain PET imaging dataset acquired in a cohort of 20- to 82-year-old, cognitively normal adults (n = 205) to define their metabolic brain age. We find that throughout the adult life span the female brain has a persistently lower metabolic brain age—relative to their chronological age—compared with the male brain. The persistence of relatively younger metabolic brain age in females throughout adulthood suggests that development might in part influence sex differences in brain aging. Our results also demonstrate that trajectories of natural brain aging vary significantly among individuals and provide a method to measure this.

SignificanceDifferences in immune functioning stem from multiple factors, including sex and aging. However, the specific roles of these variables in immunity remain elusive. We profiled immunocytes from young and old males and females at single-cell resolution and constructed a precise atlas of blood-circulating immunocytes. T cell– and B cell–activated signals were higher in young females than males, while aging increased the sex-related differences in immunocytes, cellular composition, and inflammatory signaling. Additionally, males showed a higher accumulation of inflammatory factors during aging, whereas cell–cell communication analysis revealed different trends in gene expression between females and males with aging. These findings might aid in the understanding of the mechanisms underlying sex-based differences in immunity and disease susceptibility across the lifespan. Sex and aging influence the human immune system, resulting in disparate responses to infection, autoimmunity, and cancer. However, the impact of sex and aging on the immune system is not yet fully elucidated. Using small conditional RNA sequencing, we found that females had a lower percentage of natural killer (NK) cells and a higher percentage of plasma cells in peripheral blood compared with males. Bioinformatics revealed that young females exhibited an overrepresentation of pathways that relate to T and B cell activation. Moreover, cell–cell communication analysis revealed evidence of increased activity of the BAFF/APRIL systems in females. Notably, aging increased the percentage of monocytes and reduced the percentage of naïve T cells in the blood and the number of differentially expressed genes between the sexes. Aged males expressed higher levels of inflammatory genes. Collectively, the results suggest that females have more plasma cells in the circulation and a stronger BAFF/APRIL system, which is consistent with a stronger adaptive immune response. In contrast, males have a higher percentage of NK cells in blood and a higher expression of certain proinflammatory genes. Overall, this work expands our knowledge of sex differences in the immune system in humans.

Although aging is a conserved phenomenon across evolutionary distant species, aspects of the aging process have been found to differ between males and females of the same species. Indeed, observations across mammalian studies have revealed the existence of longevity and health disparities between sexes, including in humans (i.e. with a female or male advantage). However, the underlying mechanisms for these sex differences in health and lifespan remain poorly understood, and it is unclear which aspects of this dimorphism stem from hormonal differences (i.e. predominance of estrogens vs. androgens) or from karyotypic differences (i.e. XX vs. XY sex chromosome complement). In this review, we discuss the state of the knowledge in terms of sex dimorphism in various aspects of aging and in human age-related diseases. Where the interplay between sex differences and age-related differences has not been explored fully, we present the state of the field to highlight important future research directions. We also discuss various dietary, drug or genetic interventions that were shown to improve longevity in a sex-dimorphic fashion. Finally, emerging tools and models that can be leveraged to decipher the mechanisms underlying sex differences in aging are also briefly discussed.

Sex differences in aging occur in many animal species, and they include sex differences in lifespan, in the onset and progression of age‐associated decline, and in physiological and molecular markers of aging. Sex differences in aging vary greatly across the animal kingdom. For example, there are species with longer‐lived females, species where males live longer, and species lacking sex differences in lifespan. The underlying causes of sex differences in aging remain mostly unknown. Currently, we do not understand the molecular drivers of sex differences in aging, or whether they are related to the accepted hallmarks or pillars of aging or linked to other well‐characterized processes. In particular, understanding the role of sex‐determination mechanisms and sex differences in aging is relatively understudied. Here, we take a comparative, interdisciplinary approach to explore various hypotheses about how sex differences in aging arise. We discuss genomic, morphological, and environmental differences between the sexes and how these relate to sex differences in aging. Finally, we present some suggestions for future research in this area and provide recommendations for promising experimental designs. Sex difference in aging occurs across the animal kingdom, but there is considerable variation and they are not universal. The processes leading to sex‐specific aging are poorly understood and might originate in sex‐specific genome architecture, organismal biology, or environmental interactions. Here, we take a comparative approach to review the various hypotheses and suggest promising areas of research for further study.

A robust, often underappreciated, feature of human biology is that women live longer than men not just in technologically advanced, low-mortality countries such as those in Europe or North America, but across low- and high-mortality countries of the modern world as well as through history. Women's survival advantage is not due to protection from one or a few diseases. Women die at lower rates than men from virtually all the top causes of death with the notable exception of Alzheimer's disease, to which women are particularly prone. Yet, despite this robust survival advantage, women across countries of the world suffer worse health throughout life. The biological mechanisms underlying either longer female survival or poorer female health remain elusive and understudied. Mechanisms of mammalian biology, particularly with respect to aging and disease, are most easily studied in laboratory mice. Although there are no consistent differences in longevity between mouse sexes even within single genotypes, there are often substantial differences in individual studies, sometimes favoring females, other times males. Investigating the environmental causes of this puzzling variation in longevity differences could prove illuminating. Sex differences in response to life-extending genetic or pharmacological interventions appear surprisingly often in mice. Longevity enhancement due to reduced signaling through IGF-1 or mTOR signaling typically favors females, whereas enhancement via a range of pharmacological treatments favors males. These patterns could be due to interactions of the interventions with sex steroids, with adiponectin or leptin levels, or with the sex differences in immune function or the regional distribution of body fat. Clearly, generalizations from one sex cannot be extended to the other, and inclusion of both sexes in biomedical studies of human or other animals is worth the effort and expense.