Skip to main content
  • Neurology.org
  • Journals
    • Neurology
    • Clinical Practice
    • Education
    • Genetics
    • Neuroimmunology & Neuroinflammation
  • Online Sections
    • Neurology Video Journal Club
    • Diversity, Equity, & Inclusion (DEI)
    • Neurology: Clinical Practice Accelerator
    • Practice Buzz
    • Practice Current
    • Residents & Fellows
    • Without Borders
  • Collections
    • COVID-19
    • Disputes & Debates
    • Health Disparities
    • Infographics
    • Neurology Future Forecasting Series
    • Null Hypothesis
    • Patient Pages
    • Topics A-Z
    • Translations
    • UDDA Revision Series
  • Podcast
  • CME
  • About
    • About the Journals
    • Contact Us
    • Editorial Board
  • Authors
    • Submit New Manuscript
    • Submit Revised Manuscript
    • Author Center

Advanced Search

Main menu

  • Neurology.org
  • Journals
    • Neurology
    • Clinical Practice
    • Education
    • Genetics
    • Neuroimmunology & Neuroinflammation
  • Online Sections
    • Neurology Video Journal Club
    • Diversity, Equity, & Inclusion (DEI)
    • Neurology: Clinical Practice Accelerator
    • Practice Buzz
    • Practice Current
    • Residents & Fellows
    • Without Borders
  • Collections
    • COVID-19
    • Disputes & Debates
    • Health Disparities
    • Infographics
    • Neurology Future Forecasting Series
    • Null Hypothesis
    • Patient Pages
    • Topics A-Z
    • Translations
    • UDDA Revision Series
  • Podcast
  • CME
  • About
    • About the Journals
    • Contact Us
    • Editorial Board
  • Authors
    • Submit New Manuscript
    • Submit Revised Manuscript
    • Author Center
  • Home
  • Latest Articles
  • Current Issue
  • Past Issues
  • Neurology Video Journal Club
  • Residents & Fellows

User menu

  • Subscribe
  • My Alerts
  • Log in

Search

  • Advanced search
Neurology
Home
The most widely read and highly cited peer-reviewed neurology journal
  • Subscribe
  • My Alerts
  • Log in
Site Logo
  • Home
  • Latest Articles
  • Current Issue
  • Past Issues
  • Neurology Video Journal Club
  • Residents & Fellows

Share

November 12, 2019; 93 (20) Article

Sex-specific norms for verbal memory tests may improve diagnostic accuracy of amnestic MCI

Erin E. Sundermann, Pauline Maki, Anat Biegon, Richard B. Lipton, Michelle M. Mielke, Mary Machulda, Mark W. Bondi, for the Alzheimer's Disease Neuroimaging Initiative
First published October 9, 2019, DOI: https://doi.org/10.1212/WNL.0000000000008467
Erin E. Sundermann
From the Department of Psychiatry (E.E.S., M.W.B.), University of California, San Diego; Departments of Psychiatry, Psychology, and Obstetrics & Gynecology (P.M.), University of Illinois at Chicago; Department of Radiology and Neurology (A.B.), State University of New York, Stony Brook; Einstein Aging Study and Department of Neurology (R.B.L.), Albert Einstein College of Medicine, Bronx, NY; Departments of Health Sciences Research and Neurology (M.M.M.) and Departments of Psychiatry and Psychology (M.M.), Mayo Clinic, Rochester, MN; and Veterans Affairs San Diego Healthcare System (M.W.B.), CA.
PhD
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Pauline Maki
From the Department of Psychiatry (E.E.S., M.W.B.), University of California, San Diego; Departments of Psychiatry, Psychology, and Obstetrics & Gynecology (P.M.), University of Illinois at Chicago; Department of Radiology and Neurology (A.B.), State University of New York, Stony Brook; Einstein Aging Study and Department of Neurology (R.B.L.), Albert Einstein College of Medicine, Bronx, NY; Departments of Health Sciences Research and Neurology (M.M.M.) and Departments of Psychiatry and Psychology (M.M.), Mayo Clinic, Rochester, MN; and Veterans Affairs San Diego Healthcare System (M.W.B.), CA.
PhD
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Anat Biegon
From the Department of Psychiatry (E.E.S., M.W.B.), University of California, San Diego; Departments of Psychiatry, Psychology, and Obstetrics & Gynecology (P.M.), University of Illinois at Chicago; Department of Radiology and Neurology (A.B.), State University of New York, Stony Brook; Einstein Aging Study and Department of Neurology (R.B.L.), Albert Einstein College of Medicine, Bronx, NY; Departments of Health Sciences Research and Neurology (M.M.M.) and Departments of Psychiatry and Psychology (M.M.), Mayo Clinic, Rochester, MN; and Veterans Affairs San Diego Healthcare System (M.W.B.), CA.
PhD
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Richard B. Lipton
From the Department of Psychiatry (E.E.S., M.W.B.), University of California, San Diego; Departments of Psychiatry, Psychology, and Obstetrics & Gynecology (P.M.), University of Illinois at Chicago; Department of Radiology and Neurology (A.B.), State University of New York, Stony Brook; Einstein Aging Study and Department of Neurology (R.B.L.), Albert Einstein College of Medicine, Bronx, NY; Departments of Health Sciences Research and Neurology (M.M.M.) and Departments of Psychiatry and Psychology (M.M.), Mayo Clinic, Rochester, MN; and Veterans Affairs San Diego Healthcare System (M.W.B.), CA.
MD
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Michelle M. Mielke
From the Department of Psychiatry (E.E.S., M.W.B.), University of California, San Diego; Departments of Psychiatry, Psychology, and Obstetrics & Gynecology (P.M.), University of Illinois at Chicago; Department of Radiology and Neurology (A.B.), State University of New York, Stony Brook; Einstein Aging Study and Department of Neurology (R.B.L.), Albert Einstein College of Medicine, Bronx, NY; Departments of Health Sciences Research and Neurology (M.M.M.) and Departments of Psychiatry and Psychology (M.M.), Mayo Clinic, Rochester, MN; and Veterans Affairs San Diego Healthcare System (M.W.B.), CA.
PhD
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Mary Machulda
From the Department of Psychiatry (E.E.S., M.W.B.), University of California, San Diego; Departments of Psychiatry, Psychology, and Obstetrics & Gynecology (P.M.), University of Illinois at Chicago; Department of Radiology and Neurology (A.B.), State University of New York, Stony Brook; Einstein Aging Study and Department of Neurology (R.B.L.), Albert Einstein College of Medicine, Bronx, NY; Departments of Health Sciences Research and Neurology (M.M.M.) and Departments of Psychiatry and Psychology (M.M.), Mayo Clinic, Rochester, MN; and Veterans Affairs San Diego Healthcare System (M.W.B.), CA.
PhD, LP
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Mark W. Bondi
From the Department of Psychiatry (E.E.S., M.W.B.), University of California, San Diego; Departments of Psychiatry, Psychology, and Obstetrics & Gynecology (P.M.), University of Illinois at Chicago; Department of Radiology and Neurology (A.B.), State University of New York, Stony Brook; Einstein Aging Study and Department of Neurology (R.B.L.), Albert Einstein College of Medicine, Bronx, NY; Departments of Health Sciences Research and Neurology (M.M.M.) and Departments of Psychiatry and Psychology (M.M.), Mayo Clinic, Rochester, MN; and Veterans Affairs San Diego Healthcare System (M.W.B.), CA.
PhD
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
From the Department of Psychiatry (E.E.S., M.W.B.), University of California, San Diego; Departments of Psychiatry, Psychology, and Obstetrics & Gynecology (P.M.), University of Illinois at Chicago; Department of Radiology and Neurology (A.B.), State University of New York, Stony Brook; Einstein Aging Study and Department of Neurology (R.B.L.), Albert Einstein College of Medicine, Bronx, NY; Departments of Health Sciences Research and Neurology (M.M.M.) and Departments of Psychiatry and Psychology (M.M.), Mayo Clinic, Rochester, MN; and Veterans Affairs San Diego Healthcare System (M.W.B.), CA.
Full PDF
Short Form
Citation
Sex-specific norms for verbal memory tests may improve diagnostic accuracy of amnestic MCI
Erin E. Sundermann, Pauline Maki, Anat Biegon, Richard B. Lipton, Michelle M. Mielke, Mary Machulda, Mark W. Bondi, for the Alzheimer's Disease Neuroimaging Initiative
Neurology Nov 2019, 93 (20) e1881-e1889; DOI: 10.1212/WNL.0000000000008467

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Permissions

Make Comment

See Comments

Downloads
321

Share

  • Article
  • Figures & Data
  • Info & Disclosures
  • CME Course
Loading

This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.

Abstract

Objective To examine whether the use of sex-specific norms and cut scores to identify memory impairment improves diagnostic accuracy of amnestic mild cognitive impairment (aMCI) compared to non–sex-specific (typical) norms/cut scores given the female advantage in verbal memory.

Methods We calculated sex-specific and typical norms/cut scores (age and education specific) for impairment on the Rey Auditory Verbal Learning Test in the Mayo Clinic Study of Aging. Norms/cut scores were applied to 453 women and 532 men from the Alzheimer's Disease Neuroimaging Initiative. We compared sex differences in rates of aMCI (Jak/Bondi criteria) for sex-specific vs typical norms/cut scores. Using sex-specific cut scores as the true condition and typical cut scores as the predicted condition, we categorized participants as true positives (TPs), false positives (FPs), true negative (TNs), or false negative (FNs). In cross-sectional analyses within sex, we compared positivity rates of CSF hyperphosphorylated tau/β-amyloid (Aβ) and cortical Aβ deposition ([18F]AV45 PET) and APOE ε4 frequency among diagnostic comparison groups.

Results The frequency of aMCI was higher in men when using typical norms/cut scores. Using sex-adjusted norms/cut scores led to the identification of 10% FNs (missed aMCI cases) among women and 10% FPs among men. Biomarker analyses supported the hypothesis that sex-specific diagnostic criteria improves diagnostic accuracy. Biomarkers rates were higher in FNs vs TNs and similar in FNs and TPs. Biomarker rates were lower in FPs vs TPs and similar between FPs and TNs.

Conclusion Results suggest that non–sex-specific aMCI diagnostic criteria led to a 20% diagnostic error rate. Accounting for sex differences in verbal memory performance may improve aMCI classification.

Glossary

Aβ=
β-amyloid;
AD=
Alzheimer disease;
ADNI=
Alzheimer's Disease Neuroimaging Initiative;
aMCI=
amnestic mild cognitive impairment;
ANCOVA=
analysis of covariance;
CDR-SOB=
Clinical Dementia Rating Sum of Boxes;
CI=
confidence interval;
FN=
false negative;
FP=
false positive;
NC=
normal control;
OR=
odds ratio;
p-tau=
hyperphosphorylated tau;
RAVLT=
Rey Auditory Verbal Learning Test.;
SUVR=
standardized uptake value ratio;
TN=
true negative;
TP=
true positive

Footnotes

  • Go to Neurology.org/N for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.

  • ↵* These authors contributed equally to this work.

  • Data used in preparation of this article were obtained from the Alzheimer's Disease Neuroimaging Initiative (ADNI) database (adni.loni.usc.edu). As such, the investigators within the ADNI contributed to the design and implementation of ADNI and/or provided data but did not participate in analysis or writing of this report. A complete listing of ADNI investigators can be found in Supplemental Data File and at: links.lww.com/WNL/A992.

  • CME Course: NPub.org/cmelist

  • Received November 21, 2018.
  • Accepted in final form June 5, 2019.
  • © 2019 American Academy of Neurology
View Full Text

AAN Members

We have changed the login procedure to improve access between AAN.com and the Neurology journals. If you are experiencing issues, please log out of AAN.com and clear history and cookies. (For instructions by browser, please click the instruction pages below). After clearing, choose preferred Journal and select login for AAN Members. You will be redirected to a login page where you can log in with your AAN ID number and password. When you are returned to the Journal, your name should appear at the top right of the page.

Google Safari Microsoft Edge Firefox

Click here to login

AAN Non-Member Subscribers

Click here to login

Purchase access

For assistance, please contact:
AAN Members (800) 879-1960 or (612) 928-6000 (International)
Non-AAN Member subscribers (800) 638-3030 or (301) 223-2300 option 3, select 1 (international)

Sign Up
Information on how to subscribe to Neurology and Neurology: Clinical Practice can be found here 

Purchase
Individual access to articles is available through the Add to Cart option on the article page.  Access for 1 day (from the computer you are currently using) is US$ 39.00.  Pay-per-view content is for the use of the payee only, and content may not be further distributed by print or electronic means.  The payee may view, download, and/or print the article for his/her personal, scholarly, research, and educational use.  Distributing copies (electronic or otherwise) of the article is not allowed.

Letters: Rapid online correspondence

No comments have been published for this article.
Comment

REQUIREMENTS

You must ensure that your Disclosures have been updated within the previous six months. Please go to our Submission Site to add or update your Disclosure information.

Your co-authors must send a completed Publishing Agreement Form to Neurology Staff (not necessary for the lead/corresponding author as the form below will suffice) before you upload your comment.

If you are responding to a comment that was written about an article you originally authored:
You (and co-authors) do not need to fill out forms or check disclosures as author forms are still valid
and apply to letter.

Submission specifications:

  • Submissions must be < 200 words with < 5 references. Reference 1 must be the article on which you are commenting.
  • Submissions should not have more than 5 authors. (Exception: original author replies can include all original authors of the article)
  • Submit only on articles published within 6 months of issue date.
  • Do not be redundant. Read any comments already posted on the article prior to submission.
  • Submitted comments are subject to editing and editor review prior to posting.

More guidelines and information on Disputes & Debates

Compose Comment

More information about text formats

Plain text

  • No HTML tags allowed.
  • Web page addresses and e-mail addresses turn into links automatically.
  • Lines and paragraphs break automatically.
Author Information
NOTE: The first author must also be the corresponding author of the comment.
First or given name, e.g. 'Peter'.
Your last, or family, name, e.g. 'MacMoody'.
Your email address, e.g. higgs-boson@gmail.com
Your role and/or occupation, e.g. 'Orthopedic Surgeon'.
Your organization or institution (if applicable), e.g. 'Royal Free Hospital'.
Publishing Agreement
NOTE: All authors, besides the first/corresponding author, must complete a separate Publishing Agreement Form and provide via email to the editorial office before comments can be posted.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.

Vertical Tabs

You May Also be Interested in

Back to top
  • Article
    • Abstract
    • Glossary
    • Methods
    • Results
    • Discussion
    • Author contributions
    • Study funding
    • Disclosure
    • Footnotes
    • References
  • Figures & Data
  • Info & Disclosures
  • CME Course

More Online

CME Course

Association of Mediterranean-DASH Intervention for Neurodegenerative Delay and Mediterranean Diets With Alzheimer Disease Pathology

Dr. Babak Hooshmand and Dr. David Smith

► Watch

Topics Discussed

  • Alzheimer's disease
  • Cerebrospinal Fluid
  • PET
  • MCI (mild cognitive impairment)

Alert Me

  • Alert me when eletters are published

Recommended articles

  • Article
    Female advantage in verbal memory
    Evidence of sex-specific cognitive reserve
    Erin E. Sundermann, Pauline M. Maki, Leah H. Rubin et al.
    Neurology, October 05, 2016
  • Article
    Better verbal memory in women than men in MCI despite similar levels of hippocampal atrophy
    Erin E. Sundermann, Anat Biegon, Leah H. Rubin et al.
    Neurology, March 16, 2016
  • Article
    White matter abnormalities and cognition in patients with conflicting diagnoses and CSF profiles
    Emily R. Lindemer, Douglas N. Greve, Bruce Fischl et al.
    Neurology, March 23, 2018
  • Article
    Defining the Lowest Threshold for Amyloid-PET to Predict Future Cognitive Decline and Amyloid Accumulation
    Michelle E. Farrell, Shu Jiang, Aaron P. Schultz et al.
    Neurology, November 16, 2020
Neurology: 101 (12)

Articles

  • Ahead of Print
  • Current Issue
  • Past Issues
  • Popular Articles
  • Translations

About

  • About the Journals
  • Ethics Policies
  • Editors & Editorial Board
  • Contact Us
  • Advertise

Submit

  • Author Center
  • Submit a Manuscript
  • Information for Reviewers
  • AAN Guidelines
  • Permissions

Subscribers

  • Subscribe
  • Activate a Subscription
  • Sign up for eAlerts
  • RSS Feed
Site Logo
  • Visit neurology Template on Facebook
  • Follow neurology Template on Twitter
  • Visit Neurology on YouTube
  • Neurology
  • Neurology: Clinical Practice
  • Neurology: Education
  • Neurology: Genetics
  • Neurology: Neuroimmunology & Neuroinflammation
  • AAN.com
  • AANnews
  • Continuum
  • Brain & Life
  • Neurology Today

Wolters Kluwer Logo

Neurology | Print ISSN:0028-3878
Online ISSN:1526-632X

© 2023 American Academy of Neurology

  • Privacy Policy
  • Feedback
  • Advertise