Women may be more likely to develop Alzheimer's disease, but men are typically diagnosed at earlier stages, when symptoms are mild. By tweaking memory tests a little, more women might be caught at an early stage of the disease, when they can benefit from treatment, a study suggests.
Adjusting the test scoring to take into account women’s lifelong advantage in verbal memory performance allows researchers to identify more women with the Alzheimer’s precursor, amnestic mild cognitive impairment, or aMCI, according to the report published Wednesday in Neurology.
Verbal memory refers to the ability to memorize information, to remember words and to recall stories. The same verbal ability that allows women to score higher on memory tests also helps them to compensate for the damage that Alzheimer's does to their brains for a longer period of time, the research indicates.
Notable people with Alzheimer's
Notable people with Alzheimer's
This file photo dated 04 November, 1991 shows US President Ronald Reagan giving a speech at the dedication of the library bearing his name in Simi Valley, California. He was US president from 1981 to 1989 and retreated from public life after it was revealed he was suffering from Alzheimer's disease. (Photo by J. David Ake, AFP/Getty Images)
Glenn Campbell performs during The Goodbye Tour at the Ryman Auditorium on January 3, 2012 in Nashville, Tennessee. (Photo by Ed Rode/Getty Images)
Picture dated 18 May 1991 of US actor Charles Bronson during the 44th Cannes film festival, southern France. Bronson died 30 August 2003 in Los Angeles of complications from pneumonia. (Photo by Gerard Julien, AFP/Getty Images)
392653 01: Actor Burgess Meredith performs in the television show 'The Twilight Zone.' (Photo Courtesy of Sci Fi Channel/Getty Images)
LOS ANGELES - AUGUST 31: Actor James Doohan recieves his star on the Hollywood Walk of Fame August 31, 2004 in Los Angeles, California. (Photo by Mark Mainz/Getty Images)
LONDON, UNITED KINGDOM - JANUARY 17: Malcolm Young of AC/DC performs on stage at Wembley Arena on January 17th, 1986 in London, United Kingdom. (Photo by Peter Still/Redferns)
NORMAN ROCKWELL'S AMERICA -- Pictured: Artist Norman Rockwell -- (Photo by: Gary Null/NBC/NBCU Photo Bank via Getty Images)
Publicity close up of Hollywood actress Rita Hayworth wearing ornately decorated gloves and holding a cigarette in a cigarette holder.
NEW YORK CITY - FEBRUARY 29: Aaron Copeland attends 10th Annual Grammy Awards on February 29, 1968 at the New York Hilton Hotel in New York City. (Photo by Ron Galella, Ltd./WireImage) (Photo by Ron Galella, Ltd./WireImage)
Actor Peter Falk poses as he arrives for the premiere of his new film
"Lakeboat" September 24, 2001 in Los Angeles. The film is an adaptation
of David Mamet's comic play about a grad student who takes a summer job
on a Great Lakes freighter and sees life through the eyes of his
low-brow crew members. The film opens in limited release in Los Angeles
September 28. REUTERS/Rose Prouser
Estelle Getty (Photo by Jim Smeal/WireImage)
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But there is a point at which they can't compensate any more and then they develop symptoms faster.
“The female advantage in verbal memory may actually put women at a disadvantage when it comes to diagnosing Alzheimer’s at an early stage,” said the study’s lead author, Erin Sundermann, an assistant project scientist in the department of psychiatry at the University of California, San Diego, School of Medicine. “If we just adjust the criteria to be sex specific to account for this female advantage, our results suggest it would improve diagnostic accuracy in both women and men.”
That means women wouldn’t be the only ones to benefit. With the previous criteria, 10 percent of men would be wrongly identified as having aMCI. They now would be in the normal category. At the same time, another 10 percent of women would be added to the ranks of those with an aMCI diagnosis.
For women, early diagnosis means more time to plan for the future when symptoms are mild and an opportunity to make lifestyle changes — such as improving diet and increasing exercise — that might slow the disease's progress, Sundermann said.
More precise diagnoses in men and women would also help improve accuracy in clinical trials of potential therapies, she said.
“About 20 percent diagnostic errors could really dilute important findings,” in research, she said.
Without correcting for the female verbal memory advantage, women tend to be diagnosed at a later stage of the disease, at which point, they progress very rapidly, Sundermann said.
The verbal advantage allows women “to hang on longer," she said. "But once the brain changes surpass their ability to compensate, they tank and decline faster.”
Eating habits to protect your brain from Alzheimer’s
Eating habits to protect your brain from Alzheimer’s
Fill up on fewer calories
Start your meals with veggie-packed salads or soups, or use small plates to trick your brain into thinking your meals look bigger than they actually are. Filling up on fewer calories allows you to shed pounds, which can help reverse other risks for Alzheimer’s disease, including sleep apnea, high blood pressure, and diabetes. Cutting your daily intake of calories by 30 to 50 percent also reduces your metabolic rate and therefore slows oxidation throughout the body, including the brain. It lowers blood glucose and insulin levels, too.
Eat at least five servings of fruit and vegetables every day
Higher vegetable consumption was associated with slower rate of cognitive decline in 3,718 people aged 65 years and older who participated in the Chicago Health and Aging Project. Study participants filled out food logs and agreed to undergo tests of their cognitive abilities periodically for six years. All of the study participants scored lower on cognitive tests at the end of the study than they did at the beginning, but those who consumed more than four daily servings of vegetables experienced a 40 percent slower decline in their abilities than people who consumed less than one daily serving. Make sure you can recognize the 10 early signs of Alzheimer’s every adult should know.
Use spices liberally
Herbs and spices add flavor to food, allowing you to cut back on butter, oil, and salt. Because they come from plants, many herbs and spices also contain antioxidants and offer many healing benefits, including Alzheimer’s prevention. Several different studies show that curcumin, for example, helps to reduce the risk of cancer, arthritis, depression, and Alzheimer’s disease. Just a quarter teaspoon of the spice twice a day has been shown to reduce fasting blood sugar up to 29 percent in people with type 2 diabetes. This is important because type 2 diabetes can raise your risk of developing Alzheimer’s disease.
Marinate meat before cooking
When fat, protein, and sugar react with heat, certain harmful compounds form called advanced glycation end products (AGEs). They are found in particularly high levels in bacon, sausages, processed meats, and fried and grilled foods. The consumption of high amounts of AGEs has been shown to cause harmful changes in the brain. But there’s an easy way to slash your AGE consumption: Make your food (especially meats) as moist as possible. By boiling, braising, poaching, or marinating meat and fish before grilling or broiling, you allow moisture to permeate their flesh, dramatically reducing the AGEs.
Eat coldwater fish once a week
Fish that swim in cold waters tend to develop a layer of fat to keep them warm. Called omega-3 fatty acid, this type of fat has been shown to reduce inflammation throughout the body when consumed by humans. In a study of 815 people, people who consumed fish at least once a week reduced their Alzheimer’s disease risk by 60 percent compared to people who rarely or never ate fish.
Snack on nuts and seeds
In addition to being a rich source of omega-3 fatty acids, nuts and seeds also provide a good dose of selenium and vitamin E, two other nutrients that may promote brain health. Walnuts may be a particularly potent source of edible brain protection. In addition to omega-3 fatty acids, walnuts are rich in antioxidants that have been shown to reduce Alzheimer’s disease in mice. Steer clear of these 9 habits that can seriously up your dementia risk.
Drink several cups of tea a day
Black and green tea are rich sources of antioxidants called catechins that may fend off oxidative damage throughout the body, including the brain. Green tea is also a rich source of epigallocatechin-3-gallate (EGCG), which has been shown to reduce beta-amyloid plaque and tau tangles in mice. Tea has also been shown to drop blood pressure and cholesterol levels.
Enjoy coffee in the morning
Caffeine consumed too late in the day may disturb your sleep. But coffee consumed in the morning and perhaps the early afternoon, depending on your personal caffeine sensitivity, may reduce risk. Coffee contains a chemical called eicosanoyl-5-hydroxytryptamide (EHT) that, in studies done on rats, has been shown to protect against Alzheimer’s disease. The caffeine itself may also be protective: Mice developed fewer tau tangles in their brains when their drinking water was infused with caffeine. In humans, Johns Hopkins researchers have shown that 200 milligrams of caffeine—the amount in one strong cup of coffee—can help us consolidate memories and more easily memorize new information. Don’t miss these 15 other things neurologists do to prevent Alzheimer’s.
Eat dinner with dark chocolate, not chocolate cake
Most desserts are rich in blood-sugar-spiking sugar, and recent research has linked high blood sugar levels with oxidative damage as well as an elevated production of beta-amyloid protein plaque. Chocolate, however, may be one exception. Chocolate contains antioxidant chemicals called flavonoids, protective substances also present in many brightly colored fruits and vegetables. Baby boomers who consumed chocolate-rich drinks twice a day for three months performed as well on memory tests as did people a few decades younger. In part of the same study, tests revealed that the chocolate drinks also seemed to improve blood flow to the hippocampi regions of the brain. Here are even more everyday habits that can reduce your risk of Alzheimer’s.
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Understanding sex differences in Alzheimer's
For the new study, Sundermann and her colleagues analyzed data from 453 women and 532 men who were participants in the Alzheimer’s Neuroimaging Initiative. The researchers rescored verbal memory tests with the new criteria and then looked at how well the newly scored results fit physical findings, such as biomarkers, including those measuring levels of abnormal proteins in cerebrospinal fluid, and scans designed to show how much abnormal protein might be gunking up people’s brains.
The researchers found that the biomarkers and brain scans backed up their new diagnoses. With the new criteria, women who would be considered positive for aMCI had brain scans and biomarkers that indicated the beginnings of Alzheimer’s. Men who would currently be considered normal had biomarkers and brain scans that agreed with that diagnosis.
The new study “is a persuasive first step, showing that correcting for sex differences in verbal memory performance seems to better align with the underlying biology of Alzheimer’s disease,” said Beth Snitz, an associate professor of neurology at the University of Pittsburgh and a neuropsychologist at the university’s Alzheimer Disease Research Center.
While some people might not want to know about the early signs of Alzheimer's, the new findings could help more women when they can still make plans for the future, experts said.
"As your memory becomes more impaired, you are less and less aware you are having memory problems," said Sandra Weintraub, a professor of psychiatry and behavioral sciences and the clinical board director of the Mesulam Cognitive Neurology and Alzheimer’s Disease Center at Northwestern University’s Feinberg School of Medicine. "That is the worst time to plan.”