Diagnosing Mild Cognitive Impairment in Women

Medically Reviewed by Brunilda Nazario, MD on February 04, 2020
From the WebMD Archives

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Memory slip-ups can be a normal part of getting older. They can also be side effects of medications, a temporary consequence of menopause, or early signs of dementia.

So, how can doctors tell what’s normal? New research suggests it depends on your sex.

“Women have a verbal memory advantage over men that may allow them to compensate for Alzheimer’s-related brain changes for longer than men,” says Erin Sundermann, PhD, a researcher at University of California-San Diego and author of the new study.

Cognitive tests, which include remembering as many words as possible from a list, help doctors determine whether changes in a person’s memory are cause for concern. If you score below a certain threshold, you might have mild cognitive impairment, or MCI. That’s a decline in thinking skills beyond just normal aging. MCI can, but not always, progress to dementia.

The problem with the memory tests is that cut-off scores for MCI don’t reflect that women tend to have stronger verbal memory than men.

In a study of 985 older adults, based on standard scoring, a quarter of the women and nearly half the men had MCI. But, based on sex-specific averages, just more than a third of both women and men had MCI.

To figure out which scoring method gave the correct diagnosis, the researchers looked for plaque deposits in the brain that signal the presence of Alzheimer’s. Women who had MCI based on sex-specific scores, but not based on standard scoring, had Alzheimer’s-related plaques in their brains. Men who were normal by sex-specific standards had no plaques in their brains.

“With current scoring methods, we are diagnosing men at the right time, but we are diagnosing women later when the disease is more advanced,” Sundermann says. 

Researchers have to repeat this experiment in larger, more diverse groups before doctors change their scoring methods. Until then, Sundermann says, “Women should make their concerns about memory clear to their doctors since these changes might not show up on tests.”



4 Lessons

Sundermann suggests that when women have concerns about their memory, they keep these things in mind:

“There are other causes of memory changes besides Alzheimer’s -- your medications, menopause, how you feel on any given day.”

“If you have concerns about your memory, it’s very important to tell your doctor about them.”

“Express the changes about how your cognition has changed over time as specifically as possible.”

“If you have mild cognitive impairment, it doesn’t necessarily mean that you are on the path to Alzheimer’s disease. It’s only a risk factor.”

Show Sources


Erin Sundermann, PhD, assistant project scientist, Department of Psychiatry, University of California-San Diego.

Neurology: “Sex-specific norms for verbal memory tests may improve diagnostic accuracy of amnestic MCI.”

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