Pauline Maki, PhD, Professor of Psychiatry and Psychology, Senior Research Director of the Center for Research on Women and Gender, University of Illinois, Chicago, and researchers from the University of California, San Diego, examined data from the Alzheimer's Disease Neuroimaging Initiative that suggest women have an advantage in retaining memory for words and verbal items, not only during normal aging but also during amnestic mild cognitive impairment (aMCI).
 

As the tests most frequently used to diagnose Alzheimer's disease are related to verbal memory, memory of word lists, stories and other verbal materials, researchers wanted to better understand sex differences in verbal memory and brain aging and how they may be related to sex differences in presentation and clinical course of Alzheimer's disease.

The study found that women appeared to sustain their cognitive performance in early stages of disease, compared to men, despite having moderate levels of Alzheimer's brain pathology - as measured by three brain markers (hippocampal atrophy, brain hypometabolism and cortical beta-amyloid deposition). However, at high levels of disease burden, the female advantage in verbal memory was eliminated.

"These findings may help to explain why women show a more rapid decline across a wide range of cognitive abilities after being diagnosed with Alzheimer's," said Maki. "While the female advantage may be functionally beneficial, it could mask early stages of Alzheimer's, resulting in a more severe burden of disease at the time of diagnosis, with more rapid deterioration thereafter."

When a gender-based diagnostic approach was applied, it resulted in improved diagnostic accuracy in both sexes. This suggests the need for, and value of, alternative approaches - such as sex-specific "cut points" in diagnostic tests - to improve early detection in women.