A new study has shown that because women normally score higher than men on tests of verbal memory, they may not be diagnosed with mild cognitive impairment as early as men. This can give many women a later start than they need in the treatment of Alzheimer’s. Even when they have the same levels of Alzheimer’s disease-related brain changes, such as the amount of amyloid plaque deposits in the brain or the amount of shrinkage in the hippocampus area of the brain, they are often not diagnosed accurately.
Using gender-specific scores on memory tests may change who gets diagnosed with “pre-dementia”, or mild cognitive impairment (MCI). MCI, a precursor to dementia, is when people have problems with memory and thinking skills. The difference may be as high as 20%, with possibly more women and fewer men being diagnosed, according to a study published in the online issue of Neurology®, the medical journal of the American Academy of Neurology.
In the new study, researchers used memory test scores based on sex instead of averages for both men and women. Using the sex-specific scores, researchers found that 10 percent more women were diagnosed with MCI and 10 percent fewer men were diagnosed with MCI than when the averages were used.
Implications
“If these results are confirmed, they have vital implications,” said study author Erin E. Sundermann, Ph.D., of the University of California, San Diego. “If women are inaccurately identified as having no problems with memory and thinking skills when they actually have mild cognitive impairment, then treatments are not being started and they and their families are not planning ahead for their care or their financial or legal situations. For men who are inaccurately diagnosed with mild cognitive impairment, they can be exposed to unneeded medications, along with undue stress for them and their families.’”
Study may mean improved memory treatments
Sundermann said study results also have implications for research if they are confirmed. “When the typical average cut-off scores are used for diagnosis, women might respond less to treatments in a clinical trial than men because they are at a more advanced stage of the disease, while men might not respond because some of them do not actually have MCI,” she said. “These combined factors would result in research that reduces the estimate of how well treatments work for both men and women.”
Participants of the study were mostly well-educated compared to the general population, so the results may not apply to all groups.
SUPPORT: The study was supported in part by the National Institutes of Health.
SOURCES: alzheimersweekly.com/2019/10/memory-tests-need-adjusting-for-women.html and The American Academy of Neurology
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