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11-10-2016 | Alzheimer's disease | News | Article

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Verbal memory advantage in women may delay aMCI diagnosis

medwireNews: Women have a verbal memory advantage over men in the preclinical stages of Alzheimer’s disease (AD) that should be adjusted for in tests for the condition, researchers report.

“If replicated, results suggest that aMCI [amnestic mild cognitive impairment] may be clinically detected at a more advanced disease stage in women vs men because women are better able to compensate for underlying neuropathology”, says the team, led by Erin Sundermann (Albert Einstein College of Medicine, New York, USA).

Among 1316 participants, including 672 with aMCI, 254 with AD and 390 healthy individuals, the 573 women outperformed the 743 men on the Rey Auditory Verbal Learning Test (RAVLT), for both immediate and delayed recall of a list of 15 words.

This female advantage in verbal memory was maintained despite minimal to moderate neural dysfunction, as indicated by temporal lobe glucose metabolic rates (TLGluMR) in the medium to high range.

Once TLGluMR became lower, suggestive of more advanced neural dysfunction, however, women had little or no verbal memory advantage over men.

The researchers note in Neurology that this interaction was primarily seen among the patients with aMCI and was attenuated in patients with AD, and not significant in controls.

“We suggest that the female advantage in verbal memory may represent a sex-specific form of cognitive reserve that allows women to better compensate for brain pathology and maintain normal cognitive performance”, they write.

Indeed, the team found that based on a prespecified RAVLT cutoff for impairment of below 37 for immediate recall and below 8 for delayed recall, women reached these cutoffs at a lower TLGluMR than men, at about 2.2 versus 2.6 and 2.9 versus 3.7, respectively.

“Thus, consistent with the cognitive reserve theory, verbal memory impairment was evident at a greater degree of disease burden as measured by TLGluMR in women vs men”, they report.

This delay in the clinical manifestation of verbal memory impairment and a faster transition from aMCI to AD dementia among women than men makes the timeframe for diagnosing aMCI shorter for women and “may not be captured in longitudinal assessments given every 1 to 2 years”, the researchers stress.

They therefore believe: “Implementing sex-adjusted norms in clinical verbal memory tests may improve the early detection of AD in women.”

By Lucy Piper

medwireNews is an independent medical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2016

See also:

• Women’s verbal memory advantage may mask cognitive decline

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