Sex differences in story recall decline in preclinical Alzheimer’s disease

Cowman, D, Langhough, R, Olson, H, Basche, K, Sanson-Miles, L, Bruno, D, Hermann, B, Christian, BT, Betthauser, TJ, Johnson, SC and Mueller, KD (2025) Sex differences in story recall decline in preclinical Alzheimer’s disease. Brain Communications. fcaf169. ISSN 2632-1297

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Abstract

Stage II preclinical Alzheimer's disease is defined by the presence of increased amyloid-beta evidenced by fluid and/or imaging biomarkers, in the absence of clinical signs and symptoms. Previous research suggests that preclinical sex differences exist on measures of story recall, such as the Wescher Memory Scale–Revised Logical Memory test total score. However, sex differences on a composite metric of proper names from that test have not been investigated, and the relationships between sex and amyloid positivity on longitudinal Logical Memory measures are unclear. We examined longitudinal trajectories of total score and proper names by sex (Aim 1), and by the combination of sex and amyloid status (Aim 2). N=457 Wisconsin Registry for Alzheimer’s Prevention participants with PET Pittsburgh compound B-assessed amyloid status (+/-) were included. Linear mixed-effects models were used to examine the interaction between sex and age at visit (the time variable), and sex and amyloid+/- on longitudinal total and proper name scores. Aim 1 analyses showed a main effect such that female participants, on average, scored higher than males on both total and proper name recall. The interaction between sex and age was not statistically significant, indicating that both sexes experienced a similar average rate of annual decline. Aim 2 analyses showed that amyloid positive participants, regardless of sex, showed steeper declines compared to amyloid negative, female participants (reference group). Thus while female participants generally outperformed males on story recall measures, the impact of amyloid burden on longitudinal story recall trajectories was not significantly more pronounced in females. Results emphasize the need for further exploration into sex-specific cognitive reserve mechanisms in the context of Alzheimer’s disease biomarker burden, as well as in the assessment and understanding of cognitive decline trajectories.

Item Type:	Article
Uncontrolled Keywords:	5202 Biological Psychology; 52 Psychology; Dementia; Brain Disorders; Women's Health; Biomedical Imaging; Neurodegenerative; Neurosciences; Alzheimer's Disease including Alzheimer's Disease Related Dementias (AD/ADRD); Aging; Behavioral and Social Science; Prevention; Mental Health; Acquired Cognitive Impairment; Alzheimer's Disease; 4.2 Evaluation of markers and technologies; Neurological; 3202 Clinical sciences; 3209 Neurosciences; 5202 Biological psychology
Subjects:	B Philosophy. Psychology. Religion > BF Psychology R Medicine > RC Internal medicine > RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry
Divisions:	Psychology (from Sep 2019)
Publisher:	Oxford University Press (OUP)
Date of acceptance:	1 May 2025
Date of first compliant Open Access:	20 May 2025
Date Deposited:	20 May 2025 15:22
Last Modified:	20 May 2025 15:30
DOI or ID number:	10.1093/braincomms/fcaf169
URI:	https://researchonline.ljmu.ac.uk/id/eprint/26387

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