Abstract

Objective: Subjective cognitive decline (SCD), also known as significant memory concern (SMC), has been suggested as a manifestation of Alzheimer’s Disease (AD) preceding mild cognitive impairment (MCI). This study assessed the impact of gender on cognition, amyloid accumulation, the volumes of hippocampus, entorhinal cortex (EC), fusiform and medial temporal lobe (MTA) and cerebrospinal fluid (CSF) pathology biomarkers in patients reporting SMC.Methods: Twenty-nine males (mean age ± SD: 72.3 ± 5.7 years) and 40 females (mean age ± SD: 71.0 ± 5.1 years) with SMC from the AD Neuroimaging Initiative (ADNI) were included in the study. We explored the gender discrepancies in cognition, [18F] AV45 amyloid positivity, volumes of hippocampus, EC, fusiform and MTA and CSF biomarkers.Results: Compared with females, males showed significantly worse performance in Assessment Scale-cognitive subscale 13 (ADAS-13; P = 0.004) and lower amyloid deposition (P < 0.001). However, females showed greater advantage on the task of Rey Auditory Verbal Learning Test-5 (RAVLT-5) sum (P = 0.021), RAVLT-immediate recall (P = 0.010) and reduced volumes of the hippocampus, EC, fusiform and MTA (P = 0.001, P < 0.001, P < 0.001, P = 0.007) than males. No gender differences were found in CSF Aβ42, CSF Tau and CSF P-tau (P = 0.264, P = 0.454, P = 0.353).Conclusions: These findings highlight that gender discrepancies should be considered in the interpretation of cognitive measures when evaluating SMC.

Highlights

  • Significant memory concern (SMC; known as subjective cognitive decline (SCD) or subjective memory impairment), is defined as a self-reported cognitive complaints in the absence of objective cognitive deficits, which is common in older adults (Jessen et al, 2014; Jenkins et al, 2015)

  • These findings highlight that gender discrepancies should be considered in the interpretation of cognitive measures when evaluating SMC

  • Significant memory concern (SMC; known as subjective cognitive decline (SCD) or subjective memory impairment), is defined as a self-reported cognitive complaints in the absence of objective cognitive deficits, which is common in older adults (Jessen et al, 2014; Jenkins et al, 2015)

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Summary

Introduction

Significant memory concern (SMC; known as subjective cognitive decline (SCD) or subjective memory impairment), is defined as a self-reported cognitive complaints in the absence of objective cognitive deficits, which is common in older adults (Jessen et al, 2014; Jenkins et al, 2015). Recent mounting evidences indicated that SMC is a risk factor for future accelerated cognitive decline and progression to preclinical or clinical state of Alzheimer’s disease (AD), with AD-type changes in amyloid deposition, neuroimaging and cerebrospinal fluid (CSF) biomarkers (Petersen, 2000; Visser et al, 2009; Reisberg et al, 2010; Perrotin et al, 2012; Scheef et al, 2012; Wang et al, 2012; Mitchell et al, 2014). To date, few studies have focused on the role of gender in SMC across a comprehensive profile of the cognitive assessment, neuroimaging and CSF AD biomarkers

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