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Understanding the underlying biology of cognitive loss and dementia is an important first step to developing approaches to preventing or reversing these conditions. In this issue of Neurology®, Sundermann et al.1 describe a secondary analysis of data from an Alzheimer's Disease Neuroimaging Initiative (ADNI) study that examines differences in verbal memory between men and women as a function of hippocampal volume ratio (HpVR). The association is described within 3 diagnostic groups: cognitively healthy, those with amnestic mild cognitive impairment (aMCI), and those with mild Alzheimer disease (AD). This cross-sectional analysis demonstrates that women with aMCI have better verbal memory than men despite similar levels of hippocampal atrophy as measured by the HpVR. The authors interpret this sex-related difference in performance vs atrophy as a reflection of cognitive reserve. The report has many strengths and considerations for the clinician evaluating complaints of cognitive loss. However, it is worth noting that the study also illustrates several pitfalls of secondary data analyses and limitations of use of historical data. This is especially notable because such issues can perpetuate sex biases in scientific observation.
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Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the editorial.
See page 1368
- © 2016 American Academy of Neurology
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