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Sex-Specific Criteria May Up Accuracy for Diagnosis of aMCI

THURSDAY, Oct. 10, 2019 -- There seems to be a 20 percent diagnostic error rate with use of non-sex-specific amnestic mild cognitive impairment (aMCI) diagnostic criteria, according to a study published online Oct. 9 in Neurology.

Erin E. Sundermann, Ph.D., from the University of California in San Diego, and colleagues calculated sex-specific and typical norms/cut scores for impairment on the Rey Auditory Verbal Learning Test. These norms and cut scores were applied to 453 and 532 women and men, respectively, from the Alzheimer's Disease Neuroimaging Initiative (ADNI). Sex differences were compared in the rates of aMCI (Jak/Bondi criteria) for sex-specific versus typical norms/cut scores.

The researchers found that when using typical norms/cut scores, the frequency of aMCI was higher in men. A total of 10 percent false negatives (missed aMCI cases) were identified among women and 10 percent false positives were identified among men using sex-adjusted norms/cut scores. The hypothesis that sex-specific diagnostic criteria improves diagnostic accuracy was supported by biomarker analyses. In false versus true negatives, biomarker rates were higher, and they were similar in false negatives and true positives. In false versus true positives, biomarker rates were lower and they were similar between false positives and true negatives.

"The application of sex-specific cut scores for defining verbal memory impairment improves diagnostic accuracy in both sexes and may result in earlier detection of memory impairment in women and avoid false diagnoses in men," the authors write.

Several authors disclosed financial ties to the biopharmaceutical industry; the ADNI received funding from multiple biopharmaceutical companies.

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Posted: October 2019

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