RT Journal Article SR Electronic T1 Better verbal memory in women than men in MCI despite similar levels of hippocampal atrophy JF Neurology JO Neurology FD Lippincott Williams & Wilkins SP 10.1212/WNL.0000000000002570 DO 10.1212/WNL.0000000000002570 A1 Sundermann, Erin E. A1 Biegon, Anat A1 Rubin, Leah H. A1 Lipton, Richard B. A1 Mowrey, Wenzhu A1 Landau, Susan A1 Maki, Pauline M. A1 , YR 2016 UL http://n.neurology.org/content/early/2016/03/16/WNL.0000000000002570.abstract AB Objective: To examine sex differences in the relationship between clinical symptoms related to Alzheimer disease (AD) (verbal memory deficits) and neurodegeneration (hippocampal volume/intracranial volume ratio [HpVR]) across AD stages.Methods: The sample included 379 healthy participants, 694 participants with amnestic mild cognitive impairment (aMCI), and 235 participants with AD and dementia from the Alzheimer's Disease Neuroimaging Initiative who completed the Rey Auditory Verbal Learning Test (RAVLT). Cross-sectional analyses were conducted using linear regression to examine the interaction between sex and HpVR on RAVLT across and within diagnostic groups adjusting for age, education, and APOE ε4 status.Results: Across groups, there were significant sex × HpVR interactions for immediate and delayed recall (p < 0.01). Women outperformed men among individuals with moderate to larger HpVR, but not among individuals with smaller HpVR. In diagnosis-stratified analyses, the HpVR × sex interaction was significant in the aMCI group, but not in the control or AD dementia groups, for immediate and delayed recall (p < 0.01). Among controls, women outperformed men on both outcomes irrespective of HpVR (p < 0.001). In AD dementia, better RAVLT performance was independently associated with female sex (immediate, p = 0.04) and larger HpVR (delayed, p = 0.001).Conclusion: Women showed an advantage in verbal memory despite evidence of moderate hippocampal atrophy. This advantage may represent a sex-specific form of cognitive reserve delaying verbal memory decline until more advanced disease stages.