Introduction The Montreal Cognitive Assessment (MoCA), scored from 0 to 30, is used as a screening tool for mild cognitive impairment (MCI). The current cutoff (26) may not be optimal among minorities. Methods Data from the National Alzheimer's Coordinating Center Uniform Data Set March 2018 data freeze was used to calculate optimal cutoffs for detection of MCI and dementia by race/ethnic group and education. Results Of the 3895 individuals included, 80.7% were non-Hispanic White, 15.0% were non-Hispanic Black, and 4.2% were Hispanic. Optimal cutoffs for detection of MCI were 25 among non-Hispanic Whites, 24 among Hispanics, and 23 among non-Hispanic Blacks. Optimal cutoffs for detection of dementia were 19 among non-Hispanic Whites and 16 for both non-Hispanic Blacks and Hispanics. Lower educational attainment produced lower optimal cutoffs. Discussion Our findings suggest cutoffs may need to be stratified by race/ethnicity and education to ensure detecting MCI from normal and MCI from dementia.

Sex or gender differences in the risk of Alzheimer's disease and related dementias (ADRD) differ by world region, suggesting that there are potentially modifiable risk factors for intervention. However, few epidemiological or clinical ADRD studies examine sex differences; even fewer evaluate gender in the context of ADRD risk. The goals of this perspective are to: (1) provide definitions of gender, biologic sex, and sexual orientation. and the limitations of examining these as binary variables; (2) provide an overview of what is known with regard to sex and gender differences in the risk, prevention, and diagnosis of ADRD; and (3) discuss these sex and gender differences from a global, worldwide perspective. Identifying drivers of sex and gender differences in ADRD throughout the world is a first step in developing interventions unique to each geographical and sociocultural area to reduce these inequities and to ultimately reduce global ADRD risk.

IMPORTANCEThe ongoing COVID-19 pandemic and associated mitigation measures have disrupted access to psychiatric medications, particularly for women. OBJECTIVE To assess the sex differences in trends in the prescribing of benzodiazepines, Z-hypnotics and serotonergic (selective serotonin reuptake inhibitors [SSRIs] and serotonin and norepinephrine reuptake inhibitors [SNRIs]), which are commonly prescribed for anxiety, insomnia, and depression.

Objectives To examine the association between multi-morbid chronic disease and frequency of past six months emergency department (ED) visits, by gender, in a community sample of adults from North Florida (N=7,143). Methods Using logistic regression, we estimated associations between multi-morbid chronic disease and frequent ED use, using gender as an effect modifier. Results Multi-morbid chronic disease was associated with frequent ED use overall, with a stronger association among males. Of the 7,143 respondents, 14.4% were frequent ED users, 58.0% were female, and 61.5% were Black Non-Hispanic. Major findings included that females with 3+ chronic diseases were 2.49 (95% CI= 1.7, 3.6) times as likely as females without chronic diseases to report frequent ED use, compared to males with 3+ chronic diseases, who were 4.98 (95% CI= 2.9, 8.6) times as likely as males without chronic disease to report frequent ED use. Conclusions Multi-morbid chronic disease is very strongly associated with frequent ED use among all, but the association is especially strong among males. Future research is needed to further understand this association and its implication for health care.