title: Female advantage in verbal memory: Evidence of sex-specific cognitive reserve.
abstract: 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.
authors.affiliation: From the Einstein Aging Study and the Department of Neurology (E.E.S., R.B.L.), Albert Einstein College of Medicine, Bronx, NY; Department of Psychiatry (P.M.M., L.H.R.), University of Illinois at Chicago; Helen Wills Neuroscience Institute (S.L.), University of California, Berkeley; and Department of Neurology (A.B.), State University of New York, Stony Brook. erin.sundermann@einstein.yu.edu.
authors.forename: Erin E
authors.initials: EE
authors.lastname: Sundermann
authors.affiliation: From the Einstein Aging Study and the Department of Neurology (E.E.S., R.B.L.), Albert Einstein College of Medicine, Bronx, NY; Department of Psychiatry (P.M.M., L.H.R.), University of Illinois at Chicago; Helen Wills Neuroscience Institute (S.L.), University of California, Berkeley; and Department of Neurology (A.B.), State University of New York, Stony Brook.
authors.forename: Pauline M
authors.initials: PM
authors.lastname: Maki
authors.affiliation: From the Einstein Aging Study and the Department of Neurology (E.E.S., R.B.L.), Albert Einstein College of Medicine, Bronx, NY; Department of Psychiatry (P.M.M., L.H.R.), University of Illinois at Chicago; Helen Wills Neuroscience Institute (S.L.), University of California, Berkeley; and Department of Neurology (A.B.), State University of New York, Stony Brook.
authors.forename: Leah H
authors.initials: LH
authors.lastname: Rubin
authors.affiliation: From the Einstein Aging Study and the Department of Neurology (E.E.S., R.B.L.), Albert Einstein College of Medicine, Bronx, NY; Department of Psychiatry (P.M.M., L.H.R.), University of Illinois at Chicago; Helen Wills Neuroscience Institute (S.L.), University of California, Berkeley; and Department of Neurology (A.B.), State University of New York, Stony Brook.
authors.forename: Richard B
authors.initials: RB
authors.lastname: Lipton
authors.affiliation: From the Einstein Aging Study and the Department of Neurology (E.E.S., R.B.L.), Albert Einstein College of Medicine, Bronx, NY; Department of Psychiatry (P.M.M., L.H.R.), University of Illinois at Chicago; Helen Wills Neuroscience Institute (S.L.), University of California, Berkeley; and Department of Neurology (A.B.), State University of New York, Stony Brook.
authors.forename: Susan
authors.initials: S
authors.lastname: Landau
authors.affiliation: From the Einstein Aging Study and the Department of Neurology (E.E.S., R.B.L.), Albert Einstein College of Medicine, Bronx, NY; Department of Psychiatry (P.M.M., L.H.R.), University of Illinois at Chicago; Helen Wills Neuroscience Institute (S.L.), University of California, Berkeley; and Department of Neurology (A.B.), State University of New York, Stony Brook.
authors.forename: Anat
authors.initials: A
authors.lastname: Biegon
mesh_terms: D000161:Acoustic Stimulation; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000000981:diagnostic imaging / Q000235:genetics / Q000503:physiopathology*; D001057:Apolipoproteins E / Q000235:genetics; D003072:Cognition Disorders / Q000000981:diagnostic imaging / Q000235:genetics / Q000503:physiopathology*; D058245:Cognitive Reserve / Q000502:physiology*; D003430:Cross-Sectional Studies; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000378:metabolism; D006801:Humans; D016014:Linear Models; D008297:Male; D008609:Mental Status Schedule; D009483:Neuropsychological Tests; D049268:Positron-Emission Tomography; D012727:Sex Characteristics; D014706:Verbal Learning / Q000502:physiology*
chemical_list: D001057:Apolipoproteins E; D019788:Fluorodeoxyglucose F18