Alzheimer's disease may look and act differently in men and women, recent research suggests
When Doctors Get It Wrong...Alzheimer's Disease
It's impossible to diagnose this condition with 100% certainty because the only definitive "test" is an autopsy of the patient's brain after death. Even though there are fairly accurate ways to determine that a patient might have Alzheimer's (see below), mistakes are common.
Examples: Depression is one of the most common causes of Alzheimer's-like symptoms, but doctors often fail to recognize it. Other problems, including nutritional deficiencies and medication side effects-for example, from anticholinergic drugs, such as antihistamines, incontinence medications and tricyclic antidepressants-also can cause symptoms that mimic Alzheimer's.
Surprising fact: It's estimated that 10% to 25% of patients with symptoms of dementia (such as memory problems and/or peculiar behavior) may have a non-Alzheimer's condition that could be reversed with proper treatment.
What to do: Don't accept a diagnosis of Alzheimer's disease after a single office visitor after taking a simplo questionnaire. Specialists (such as neurologists) take a very detailed personal and family history...conduct neurological and mental status tests...and order a variety of blood and imaging tests to determine whether other conditions might be involved.
An emerging field known as gender-specific medicine has shown pronounced differences among the sexes in terms of heart disease and other conditions. These latest findings-if confirmed by further research--may have significant implications for diagnosing and treating Alzheimer's among the sexes.
When people develop Alzheimer's disease, their brains atrophy or shrink. In the study of 109 people with newly diagnosed Alzheimer's, brain scans showed that this atrophy happened earlier in women than men. Women also lost more gray matter in their brains in the year before their diagnosis. However, men seemed to have more problems with their thinking ability when diagnosed with Alzheimer's than their female counterparts did. What's more, men and women lost gray matter in different areas of their brain.
"It is commonly known that loss of volume in hippocampus coincides with cognitive decline, but this is more true in males than females," said study author Maria Vittoria Spampinato, MD, an associate professor of radiology at the Medical University of South Carolina.
The hippocampus is the part of the brain tasked with memory formation, organization and storage.
"The next step is to integrate this information on brain volume loss with other markers of Alzheimer's disease to understand if gender differences exist with other modalities or just brain volume alone," Dr. Spampinato said.
The study was presented at the annual meeting of the Radiological Society of North America.
Clinton Wright, MD, scientific director of Evelyn F. McKnight Brain Institute at the University of Miami Miller School of Medicine, said it's too soon to draw any conclusions about gender differences in Alzheimer's disease.
"Additional information would need to be provided to know if the findings are attributable to sex differences or other factors," Dr. Wright said. "In particular, it is not clear if the authors adjusted for age. If women were older they might have had greater volume losses over the study period."
Poor Sleep Linked to Alzheimer's.
People who wake up frequently (more than five times in an hour) or who are awake for more than 15% of the time that they are in bed are significantly more likely than better sleepers to show physiological changes associated with early Alzheimer's disease, according to a recent study.
Not yet known: Whether it is poor sleep that causes the brain changes-or vice versa.
The finding that women had greater brain volume losses while men had worse mental function at the time of Alzheimer's diagnosis is also hard to explain, Dr. Wright said: "One would expect greater atrophy in those with worse cognition unless additional factors such as vascular damage explained these differences."
