Test for mild cognitive impairment according to sex?

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Scoring memory tests according to sex would possibly result in more women and fewer men getting a diagnosis of mild cognitive impairment, research finds.

Using sex-specific scores on the tests could also change the diagnosis for 20% of those currently diagnosed with mild cognitive impairment (MCI), according to the study in Neurology.

Coauthor Anat Biegon, director of the Center on Gender, Hormones, and Health at the Renaissance School of Medicine at Stony Brook University, says future confirmation of these results could ultimately change the testing of men and women for dementia.

MCI, considered a precursor to dementia, is when people have memory and thinking skill problems. Because women typically score higher than men on tests of verbal memory, they may not be diagnosed with MCI as early as men are when they have the same levels of Alzheimer’s disease-related brain changes, such as the amount of amyloid plaque deposits in the brain or amount of shrinkage in the hippocampus area of the brain.

In the study, researchers used memory test scores based on sex instead of averages for both men and women. Using the sex-specific scores, they found that 10% more women received an MCI diagnosis and 10% fewer men did than when using the averages.

“There are numerous implications to our findings if they are confirmed,” says Biegon, also a professor of radiology and neurology. They are:

If women are inaccurately identified as having no problems with memory and thinking skills when they actually have mild cognitive impairment, then treatments are not being started early enough, and they and their families are not planning ahead for their care or financial or legal situations.

If men are inaccurately diagnosed with mild cognitive impairment, they can be exposed to unneeded medications along with undue stress for them and their families,” she explains.

The study involved 985 people from the Alzheimer’s Disease Neuroimaging Initiative. All of the participants took a verbal memory test that involves learning a list of 15 unrelated words and recalling as many as possible in five immediate tests, where scores range from 0 to 75, and also after learning another list and then a 30- minute delay, where scores range from 0 to 15.

Overall, using typical scores bases on averages across men and women, 26% of women were diagnosed with MCI and 45% of men were diagnosed with MCI. With sex-specific scores, 36% of women, and 35% of men, respectively, were diagnosed with MCI.

The National Institutes of Health supported the work.

Source: Stony Brook University