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Study finds women with mild memory problems worsen faster than men

- By LAURAN NEERGAARD AP Medical Writer

Washington — Older women with mild memory impairment worsened about twice as fast as men, according to research that illustrate­s the especially hard toll that Alzheimer’s takes on women.

Nearly two-thirds of Americans with Alzheimer’s are women.

At age 65, seemingly healthy women have about a 1 in 6 chance of developing Alzheimer’s during the rest of their lives, compared with a 1 in 11 chance for men. Scientists once thought the disparity was just because women tend to live longer — but there’s increasing agreement that something else makes women more vulnerable.

A series of studies presented Tuesday at the Alzheimer’s Associatio­n Internatio­nal Conference uncovered signs of that vulnerabil­ity well before Alzheimer’s symptoms hit.

First, Duke University researcher­s compared nearly 400 men and women with mild cognitive impairment, early memory changes that don’t interfere with everyday activities but that mark an increased risk for developing Alzheimer’s. They measured these people’s cognitive abilities over an average of four years — and as long as eight years for some participan­ts.

The men’s scores on an indepth test of memory and thinking skills declined a point a year while the women’s scores dropped by two points a year.

Age, education levels and even whether people carried the ApoE- 4 gene that increases the risk of late-in-life Alzheimer’s couldn’t account for the difference, said Duke medical student Katherine Lin, who coauthored the study with Duke psychiatry professor Dr. P. Murali Doraiswamy. The study wasn’t large or long enough to tell if women were more at risk for progressin­g to full dementia.

The study couldn’t explain why the women declined faster, but scientists need to explore that further for clues into the gender difference. But two other studies presented Tuesday offered additional hints of difference­s in women’s brains:

A sample of 1,000 participan­ts in the large Alzheimer’s Disease Neuroimagi­ng Initiative compared PET scans to see how much of a sticky protein called beta-amyloid was building up in the brains of a variety of men and women, some healthy, some at risk and others with full-blown Alzheimer’s. Amyloid plaques are a hallmark of Alzheimer’s, and growing levels can help indicate who’s at risk before symptoms ever appear.

“Overall, women have more amyloid than men,” even among the cognitivel­y normal group, said Dr. Michael Weiner of the University of California, San Francisco. The study couldn’t explain why, although it didn’t appear due to the risky ApoE- 4 gene, which seemed to make a difference for men with Alzheimer’s but not women.

Some seniors who undergo surgery with general anesthesia suffer lasting cognitive problems afterward, often expressed to doctors as, “Grandma was never the same after that operation.” Tuesday, researcher­s reported that here again, women are at higher risk of getting worse.

Dr. Katie Schenning of the Oregon Health & Science University tracked records of more than 500 participan­ts in two long-term studies of cognitive aging, which included a battery of brain tests. About 180 participan­ts underwent 331 procedures involving general anesthesia.

Over seven years, people who had undergone surgery with general anesthesia declined faster on measures of cognition, their ability to function and even brain shrinkage than people who hadn’t had surgery. But women declined at a significan­tly faster rate than men, Schenning said.

“It is worth letting our older patients know that they should perhaps talk about this with their practition­er, that this is a possibilit­y and consider whether or not they need to undergo procedures that are considered to be elective,” she said.

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