RT Journal Article
SR Electronic
T1 Female advantage in verbal memory
JF Neurology
JO Neurology
FD Lippincott Williams & Wilkins
SP 1916
OP 1924
DO 10.1212/WNL.0000000000003288
VO 87
IS 18
A1 Erin E. Sundermann
A1 Pauline M. Maki
A1 Leah H. Rubin
A1 Richard B. Lipton
A1 Susan Landau
A1 Anat Biegon
A1 For the Alzheimer's Disease Neuroimaging Initiative
YR 2016
UL http://n.neurology.org/content/87/18/1916.abstract
AB Objective: We investigated sex differences in verbal memory across different levels of neural dysfunction, measured by temporal lobe glucose metabolic rates (TLGluMR).Methods: Three hundred ninety controls and 672 participants with amnestic mild cognitive impairment (aMCI) and 254 with Alzheimer disease (AD) dementia from the Alzheimer's Disease Neuroimaging Initiative completed the Rey Auditory Verbal Learning Test (RAVLT) and [18F]-fluorodeoxyglucose–PET. Cross-sectional analyses were conducted using linear regression to examine the sex by TLGluMR interaction on RAVLT performance in the overall sample and within diagnostic groups adjusting for age, education, and APOE ε4 genotype.Results: Across groups, female sex and higher TLGluMR and their interaction were associated with better verbal memory (p values ≤ 0.005). The female advantage in verbal memory varied by TLGluMR such that the advantage was greatest among individuals with moderate to high TLGluMR and minimal or absent among individuals with lower TLGluMR. Diagnosis-stratified analyses revealed that this interaction was driven by the aMCI group (p values = 0.009). The interaction was not significant in control and AD dementia groups.Conclusions: Women show better verbal memory than men in aMCI despite similar levels of brain hypometabolism. The lifelong advantage that females show over males in verbal memory might represent a form of cognitive reserve that delays verbal memory decline until more advanced pathology, as indexed by TLGluMR. This issue is clinically important because verbal memory scores are used in diagnosing aMCI and AD dementia.AD=Alzheimer disease; ADNI=Alzheimer's Disease Neuroimaging Initiative; aMCI=amnestic mild cognitive impairment; CDR=Clinical Dementia Rating; FDG=[18F]-fluorodeoxyglucose; HpVR=hippocampal volume ratio; LM-II=Logical Memory II; MMSE=Mini-Mental State Examination; RAVLT=Rey Auditory Verbal Learning Test; ROI=region of interest; TLGluMR=temporal lobe glucose metabolic rates