Alzheimer’s disease in women: Mental deterioration faster than men, memory skills may mask early signs

Alzheimer's disease

In Alzheimer’s disease, mental deterioration in women is faster, compared to men. The researchers found that women performed significantly worse on cognitive tests, compared to men with Alzheimer’s disease. The most significant differences were seen in verbal skills between female and male patients with Alzheimer’s.


Lead researcher Keith Laws said, “Unlike mental decline associated with normal aging, something about Alzheimer’s specifically disadvantages women. There has been some previous, but limited, evidence that females with Alzheimer’s deteriorate faster than males in the earlier stages of the disease. And possible explanations are for a hormonal influence, possibly due to estrogen loss in women or, perhaps, a greater cognitive reserve in males which provides protection against the disease process. But further studies to examine sex differences with the disease are needed to provide greater clarity on these issues.”

Additional analysis revealed that age, education, and dementia severity did not explain the disadvantage that women have, compared to men.

Verbal memory skills of women with Alzheimer’s disease mask early signs

A more recent study found that better verbal memory skills in women may mask the early signs of Alzheimer’s disease. Study author Erin E. Sundermann explained, “Women perform better than men on tests of verbal memory throughout life, which may give them a buffer of protection against losing their verbal memory skills in the precursor stages of Alzheimer’s disease, known as mild cognitive impairment. This is especially important because verbal memory tests are used to diagnose people with Alzheimer’s disease and mild cognitive impairment, so women may not be diagnosed until they are further along in the disease.”

The study included 254 Alzheimer’s disease patients, 672 people with mild cognitive impairments (MCI), and 390 without any memory or thinking problems.

Saundermann added
, “These results suggest that women are better able to compensate for underlying changes in the brain with their ‘cognitive reserve’ until the disease reaches a more advanced stage.”

The immediate recall test has a maximum score of 75, and memory is considered impaired with a score of 37 or less. Women reached impaired memory scores quicker than men at a lower glucose metabolism.

Saundermann explained, “If these results are confirmed, adjusting memory tests to account for the differences between men and women may help diagnose Alzheimer’s disease earlier in women.”

Previous studies have found that women with Alzheimer’s disease tend to hold onto their verbal memory skills longer than men. This can delay diagnosis of Alzheimer’s disease in women. The differences remain even though men and women have similar brain shrinkage in the areas that reveal early Alzheimer’s disease.


Study author Erin Sundermann said, “One way to interpret the results is that because women have better verbal memory skills than men throughout life, women have a buffer of protection against loss of verbal memory before the effects of Alzheimer’s disease kick in. Because verbal memory tests are used to diagnose people with Alzheimer’s disease and its precursor, mild cognitive impairment, these tests may fail to detect mild cognitive impairment and Alzheimer’s disease in women until they are further along in the disease.”

If the study findings are confirmed, testing for women and men has to be differentiated in order to properly diagnose Alzheimer’s disease.

Mary Sano wrote in an accompanying editorial, “At a public policy level, the potential healthcare cost for under-detection or delayed diagnosis of women with Alzheimer’s disease or its early stages is staggering and should motivate funding in this area.”

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