Women's better memory skills may mask Alzheimer's symptoms

Women with symptoms of Alzheimer's disease tend to have better verbal memory skills than men, which may cause the disorder to go undetected till it is at an advanced stage, a new study has found.
"Women perform better than men on tests of verbal memory throughout life, which may give them a buffer of protection against losing their verbal memory skills in the precursor stages of Alzheimer's disease, known as mild cognitive impairment," said Erin E Sundermann, who conducted the research at Albert Einstein College of Medicine in the US.
"This is especially important because verbal memory tests are used to diagnose people with Alzheimer's disease and mild cognitive impairment, so women may not be diagnosed until they are further along in the disease," said Sundermann, now at the University of California, San Diego.

The study included people from the Alzheimer's Disease Neuroimaging Initiative - 254 people with Alzheimer's disease, 672 people with mild cognitive impairment that included memory problems and 390 people with no thinking or memory problems.
Participants' verbal memory skills were tested and positron emission tomography (PET) brain scans measured how well their brains metabolised glucose, which is the primary energy source for the brain. Poor metabolism is a sign of dysfunction in brain cells.
The memory test asked participants to remember a list of 15 words read to them, both right away and 30 minutes later.

Women scored better than men on the memory tests when they had no, mild or moderate problems with brain metabolism.

Once the participants had more advanced metabolism problems, there was no difference in test scores between women and men.
"These results suggest that women are better able to compensate for underlying changes in the brain with their 'cognitive reserve' until the disease reaches a more advanced stage," Sundermann said.
The immediate recall test has a maximum score of 75; memory is considered impaired when scores are less than 37.
The study looked at a rate of glucose metabolism in the temporal lobe (brain area responsible for memory function) relative to glucose metabolism in the pons/cerebellum (brain area where metabolism remains stable with increasing age and pathology).

This temporal lobe glucose metabolism rate ranges from one to four, with lower scores indicating more dysfunction in brain cells.
In the study, women reached the impaired scores at a lower metabolism rate than men, or a temporal lobe glucose metabolism rate of 2.2 compared to 2.6.
The delayed recall test has a maximum score of 15 and scores of less than eight are considered impaired. Women in the study had impaired scores at a glucose metabolism rate of 2.9 compared to 3.7 for men.
"If these results are confirmed, adjusting memory tests to account for the differences between men and women may help diagnose Alzheimer's disease earlier in women," Sundermann said.

The study appears in the journal Neurology.