TY - JOUR
T1 - Better verbal memory in women than men in MCI despite similar levels of hippocampal atrophy
AU - Sundermann, Erin E.
AU - Biegon, Anat
AU - Rubin, Leah H.
AU - Lipton, Richard B.
AU - Mowrey, Wenzhu
AU - Landau, Susan
AU - Maki, Pauline M.
N1 - Funding Information:
Data collection and sharing for this project was funded by the Alzheimers Disease Neuroimaging Initiative (ADNI) (NIH grant U01 AG024904). ADNI is funded by the National Institute on Aging, the National Institute of Biomedical Imaging and Bioengineering, and through contributions from nonprofit partners the Alzheimers Association and Alzheimers Drug Discovery Foundation, with participation from the US Food and Drug Administration and from the following: Abbott; Alzheimers Association; Alzheimers Drug Discovery Foundation; Amorfix Life Sciences Ltd.; AstraZeneca; Bayer HealthCare; Bio-Clinica, Inc.; Biogen Idec Inc.; Bristol-Myers Squibb Company; Eisai Inc.; Elan Pharmaceuticals Inc.; Eli Lilly and Company; F. Hoffmann-La Roche Ltd. and its affiliated company Genentech, Inc.; E Healthcare; Innogenetics, N.V.; IXICO Ltd.; Janssen Alzheimer Immunotherapy Research and Development, LLC; Johnson and Johnson Pharmaceutical Research and Development LLC; Medpace, Inc.; Merck and Co., Inc.; Meso Scale Diagnostics, LLC; Novartis Pharmaceuticals Corporation; Pfizer Inc.; Servier; Synarc Inc.; and Takeda Pharmaceutical Company. Drs. Sundermann and Liptons time was supported by funding for the Einstein Aging Study: National Institute on Aging Grant AG003949, AG026728, TL1RR000087, T32-GM007288, the Leonard and Sylvia Marx Foundation, and the Czap Foundation.
Publisher Copyright:
© 2016 American Academy of Neurology.
PY - 2016/4/12
Y1 - 2016/4/12
N2 - 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.
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.
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U2 - 10.1212/WNL.0000000000002570
DO - 10.1212/WNL.0000000000002570
M3 - Article
C2 - 26984945
AN - SCOPUS:84964887215
SN - 0028-3878
VL - 86
SP - 1368
EP - 1376
JO - Neurology
JF - Neurology
IS - 15
ER -