Sex / gender bias on the Face‐Name Associative Memory Exam in clinically‐normal older adults

Abstract

AbstractBackgroundMany studies of memory in older adults report a sex difference, usually with female participants scoring slightly better than males. These sex differences may be partially due to the content of the tests, with some content being more memorable to males or females (https://doi.org/10.1093/ARCLIN/ACAC102). We investigated whether male and female older adults show differences on the Face‐Name Associative Memory Exam (FNAME‐12, designed to detect subtle Alzheimer’s disease‐related memory impairment). Specifically, do they show a bias towards remembering the stimuli that match their own sex?MethodParticipants (n = 432, see Table 1) in ‘Insight 46’, a sub‐study of the MRC National Survey of Health and Development (British 1946 birth cohort), completed FNAME‐12 (version A) at age ∼73 years. Stimuli comprise six male and six female faces (presented in alternating order), with names and occupations. Recall is tested four times after various delay intervals. Four total scores were calculated across all recall trials: female names; female occupations; male names; male occupations. We fitted multivariable regression models using Generalised Estimating Equations to investigate effects of item type (name/occupation), item gender (male/female) and participant sex (male/female), and interactions between these variables, controlling for age, education, socioeconomic position and prospectively‐collected childhood cognitive ability.ResultWomen outperformed men (coefficient averaged across the four conditions = 2.2 points [95% CIs 1.3, 3.1], p<0.001) (Fig1; Fig2). This difference was exaggerated for female stimuli (interaction coefficient = 2.0 [1.4, 2.6], p<0.001), and female stimuli occupations (3‐way interaction coefficient = 0.8 [‐0.0, 1.6] p = 0.050) i.e. women scored better than men even on male names, whereas men were particularly disadvantaged at recalling information associated with female stimuli, especially their occupations (Fig2).ConclusionWe found evidence of a gender bias on FNAME‐12 among male participants, where their recall was worse for female stimuli compared to male stimuli, which may partially explain their poorer performance on this test. Such biases should be considered when interpreting sex differences on memory tests. Further analyses before the conference will investigate longitudinal FNAME‐12 performance over ∼2.4 years, to explore whether this memory bias remains constant, or whether it may be a marker of memory decline (potentially reflecting increased reliance on the relatability of test content).