Sex differences in cognition in healthy elderly individuals

ABSTRACT

Sex differences in patterns of cognitive test performance have been attributed to factors, such as sex hormones or sexual dimorphisms in brain structure, that change with normal aging. The current study examined sex differences in patterns of cognitive test performance in healthy elderly individuals. Cognitive test scores of 957 men and women (age 67–89), matched for overall level of cognitive test performance, age, education, and depression scale score, were compared. Men and women were indistinguishable on tests of auditory divided attention, category fluency, and executive functioning. In contrast, women performed better than men on tests of psychomotor speed and verbal learning and memory, whereas men outperformed women on tests of visuoconstruction and visual perception. Our finding that the pattern of sex differences in cognition observed in young adults is observed in old age has implications for future studies of both healthy elderly individuals and of those with cognitive disorders.     

Sex differences in cognition are stable over a 10-year period in adulthood and old age

Sex differences in declarative memory and visuospatial ability are robust in cross-sectional studies. The present longitudinal study examined whether sex differences in cognition were present over a 10-year period, and whether age modified the magnitude of sex differences. Tests assessing episodic and semantic memory, and visuospatial ability were administered to 625 nondemented adults (initially aged 35-80 years), participating in the population-based Betula study at two follow-up occasions. There was stability of sex differences across five age groups and over a 10-year period. Women performed at a higher level than men on episodic recall, face and verbal recognition, and semantic fluency, whereas men performed better than women on a task-assessing, visuospatial ability. Sex differences in cognitive functions are stable over a 10-year period and from 35 to 90 years of age.     

Sex Differences in Cognition are Stable Over a 10-Year Period in Adulthood and Old Age

ABSTRACT

Sex differences in declarative memory and visuospatial ability are robust in cross-sectional studies. The present longitudinal study examined whether sex differences in cognition were present over a 10-year period, and whether age modified the magnitude of sex differences. Tests assessing episodic and semantic memory, and visuospatial ability were administered to 625 nondemented adults (initially aged 35–80 years), participating in the population-based Betula study at two follow-up occasions. There was stability of sex differences across five age groups and over a 10-year period. Women performed at a higher level than men on episodic recall, face and verbal recognition, and semantic fluency, whereas men performed better than women on a task-assessing, visuospatial ability. Sex differences in cognitive functions are stable over a 10-year period and from 35 to 90 years of age.     

The association of motor information and verbal information: a new perspective on the mechanism of the SPT effect

Current perspectives on the mechanism underlying the Subject Performed Task (SPT) effect have not yet reached a consensus. This study investigated whether the association between motor and verbal information is a key factor that explains the SPT effect. Experiment 1 and 2 tested whether motor and verbal retrieval memory performance were different when the association level was varied. Results showed that when subjects used low association learning materials, memory performance in either motor or verbal retrieval condition was significantly better than performance in the combined retrieval condition. Experiment 3 examined whether the level of association between motor and verbal information affects the SPT effect. Results revealed that the SPT effect disappeared when low association learning materials were used. Our findings imply that the high association level between motor and verbal information enables mutual activation of the two information types, leading to improved memory performance.     

Sex differences in face recognition--women's faces make the difference

Sex differences favoring women have been found in face recognition tasks as well as in verbal episodic memory tasks. Women's higher face recognition performance was hypothesized to be related to either their higher verbal ability or to their superiority in recognizing female faces, rather than faces in general. Results showed that whereas there were no differences between men and women in the recognition of male faces, or in verbal ability, women performed at a higher level than men in the recognition of female faces. Verbal ability did not influence women's face recognition performance. Potential explanations for this pattern of data, such as sex differences in interest and prior knowledge, are discussed.     

Sex differences in strategy and performance on computerized neuropsychological tests as related to gender identity and age at puberty

Neuropsychological sex differences have since long been under debate. Support for the relation between behavioral differences and biological variables like hormone influence is, however, emerging. Sixteen men and sixteen women, all university students, were tested with computerized neuropsychological tests (APT), the Bem Sexual Role Inventory, and asked about pubertal age. The results were in line with earlier findings of sex differences in neuropsychological tests, men being faster and women more cautious. The assumption that women tend to use left-hemispheric, verbal/serial strategies also in spatial tasks was also partly supported. In women, late onset of puberty was related to better spatial performance, and there were also more intercorrelations between verbal and spatial tests in the female than in the male group, indicating that women use less specific strategies (more g-factor intelligence) in problem solving, or that aptitudes are less compartmentalized in women than in men.     

Sex differences in episodic memory: minimal influence of estradiol

Sex differences exist for several cognitive tasks and estrogen has been suggested to influence these differences. Eighteen men and 18 women were matched on age and estradiol level. Potential sex differences were assessed in episodic memory, semantic memory, verbal fluency, problem solving, and visuospatial ability. Significant sex differences, favoring women, were found for tasks assessing episodic memory. Correlations between estradiol level and cognitive performance were significant for face recognition in females. Since sex differences remained in verbal episodic memory tasks and face recognition despite matched levels of estradiol, circulating estradiol does not appear to be of paramount consequence for observed sex differences in episodic memory.     

Cognitive functioning in healthy older adults aged 64-81: a cohort study into the effects of age, sex, and education

The objective of this study was to determine a possible differential effect of age, education, and sex on cognitive speed, verbal memory, executive functioning, and verbal fluency in healthy older adults. A group of 578 healthy participants in the age range of 64-81 was recruited from a large population study of healthy adults (Maastricht Aging Study). Even in healthy individuals in this restricted age range, there is a clear, age-related decrease in performance on executive functioning, verbal fluency, verbal memory, and cognitive speed tasks. The capacity to inhibit information is affected most. Education had a substantial effect on cognitive functioning: participants with a middle or high level of education performed better on cognitive tests than did participants with a low level of education. Women performed better than men on verbal memory tasks. Therefore, education and sex must be taken into account when examining an older individual's cognitive performance.     

Gender differences in adult word learning

In prior work, women were found to outperform men on short-term verbal memory tasks. The goal of the present work was to examine whether gender differences on short-term memory tasks are tied to the involvement of long-term memory in the learning process. In Experiment 1, men and women were compared on their ability to remember phonologically-familiar novel words and phonologically-unfamiliar novel words. Learning of phonologically-familiar novel words (but not of phonologically-unfamiliar novel words) can be supported by long-term phonological knowledge. Results revealed that women outperformed men on phonologically-familiar novel words, but not on phonologically-unfamiliar novel words. In Experiment 2, we replicated Experiment 1 using a within-subjects design, and confirmed gender differences on phonologically-familiar, but not on phonologically-unfamiliar stimuli. These findings are interpreted to suggest that women are more likely than men to recruit native-language phonological knowledge during novel word-learning.     

Hemisphere size asymmetry predicts relative verbal and nonverbal intelligence differently in the sexes: An MRI study of structure—Function relations

Hemispheric size asymmetry differences as assessed from MRIs of 39 healthy college students were correlated with prorated WAIS-R Verbal IQ minus Performance IQ and Vocabulary minus Block Design scores within subjects. In men, a relatively larger left hemisphere predicted better verbal than nonverbal ability, whereas in women a larger left hemisphere predicted relatively better nonverbal than verbal ability. The results were interpreted as providing evidence for sex differences in brain organization.     

An fMRI study of sex differences in regional activation to a verbal and a spatial task

Sex differences in cognitive performance have been documented, women performing better on some phonological tasks and men on spatial tasks. An earlier fMRI study suggested sex differences in distributed brain activation during phonological processing, with bilateral activation seen in women while men showed primarily left-lateralized activation. This blood oxygen level-dependent fMRI study examined sex differences (14 men, 13 women) in activation for a spatial task (judgment of line orientation) compared to a verbal-reasoning task (analogies) that does not typically show sex differences. Task difficulty was manipulated. Hypothesized ROI-based analysis documented the expected left-lateralized changes for the verbal task in the inferior parietal and planum temporal regions in both men and women, but only men showed right-lateralized increase for the spatial task in these regions. Image-based analysis revealed a distributed network of cortical regions activated by the tasks, which consisted of the lateral frontal, medial frontal, mid-temporal, occipitoparietal, and occipital regions. The activation was more left lateralized for the verbal and more right for the spatial tasks, but men also showed some left activation for the spatial task, which was not seen in women. Increased task difficulty produced more distributed activation for the verbal and more circumscribed activation for the spatial task. The results suggest that failure to activate the appropriate hemisphere in regions directly involved in task performance may explain certain sex differences in performance. They also extend, for a spatial task, the principle that bilateral activation in a distributed cognitive system underlies sex differences in performance.     

Gender differences in episodic memory

The relationship between gender and memory has been largely neglected by research, despite occasional studies reporting gender differences in episodic memory performance. The present study examined potential gender differences in episodic memory, semantic memory, primary memory, and priming. Five hundred thirty women and 470 men, randomly sampled from the city of Umeå, Sweden, 35–80 years of age, participated in the study. There were no differences between men and women with regard to age or education, or on a measure of global intellectual functioning. As has been demonstrated previously, men outperformed women on a visuospatial task and women outperformed men on tests of verbal fluency. In addition, the results demonstrated that women consistently performed at a higher level than did men on the episodic memory tasks, although there were no differences between men and women on the tasks assessing semantic memory, primary memory, or priming. The women’s higher level of performance on the episodic memory tasks could not be fully explained by their higher verbal ability.     

Sex Differences in Episodic Memory

ABSTRACT— Research shows sex differences in episodic memory. These differences vary in magnitude as a function of the type of material to be remembered. Throughout the life span, verbal episodic-memory tasks yield differences favoring women. In contrast, episodic-memory tasks requiring visuospatial processing result in differences favoring men. There are also sex differences favoring women on episodic-memory tasks requiring both verbal and visuospatial processing and on face-recognition tasks. Thus, there may be a small, general episodic-memory advantage for women—an advantage that can increase by the advantage women have over men in verbal production and can be reversed by the male advantage in visuospatial tasks. In addition, environmental factors affect the magnitude of the sex differences in episodic memory.     

Sex differences in verbal fluency: the role of strategies and instructions

Sex differences in verbal fluency performance and strategies are highly controversial, nevertheless suggesting a slight female advantage at least for phonemic fluency. A tendency of increased clustering of words into phonemic and semantic subcategories in men and increased switching between those categories in women has been suggested. In spatial tasks, it has been demonstrated that changes in instructions favoring a certain cognitive strategy can alter sex differences in performance. Such an approach has, however, not been attempted previously with verbal tasks. In the present investigation, 19 women in their luteal cycle phase and 23 men performed a phonemic and a semantic fluency task with three different instructions, one neutral, one emphasizing the clustering, and one emphasizing the switching of words. While under neutral instructions no sex differences were observed in verbal fluency performance and strategies, sex differences in switching and overall performance were observed in semantic fluency with an instruction requiring a switching strategy. Furthermore, correlation analyses suggested that the importance of strategies for overall performance differed between women and men. While only switching, but not clustering was related to overall verbal fluency performance in all tasks under all instructions, this relationship was driven by women in the phonemic task, but by men in the semantic task. These results highlight the importance of a consistent methodology in sex difference research. Slight variations in instructions may in part explain inconsistencies regarding sex differences in verbal fluency between previous studies.     

Sex differences in recollective experience for olfactory and verbal information

We examined recollective experience as a function of sex for olfactory and verbal information. In the first study, men and women studied a set of highly familiar odors with incidental or intentional encoding instructions. In the second study, participants were presented with a number of sentences. At recognition, participants indicated whether their positive response was based on conscious recollection (remembering), a feeling of familiarity (knowing), or guessing. The results indicated that recollection was higher among women than men, and that familiarity-based recognition was equally large across sex for both types of information.The finding that the sex-related experiential difference disappeared when controlling for verbal proficiency suggests that sex-related differences in activating verbal information play an important role for sex differences in recollective experience.     

Verbal and visuo-spatial memory Two clinical tests administered to a group of normal subjects

Abstract.— A group of 165 normal subjects were examined on two memory tests in clinical use, the Word Pairs Test and the Visual Gestalts Test. The purpose of the study was to establish norms with the variables of age, sex, and length of schooling being taken into consideration. During the learning phase a complex interaction between all three factors was found for the Word Pairs, whereas in the Visual Gestalts scores were only affected by age. In the delayed memory task used in both tests, age was again found to be the only significant factor. Using quartile scores, it was found that females performed better than males on the verbal test and vice versa on the visuo-spatial test. Normative data are presented for three age groups. A significant decline in performance appeared in the age group 40–49 years. The data became more heterogenous with an increase in the age of the subjects.     

Sex differences in working memory

In two separate studies, sex differences in modal-specific elements of working memory were investigated by utilizing words and pictures as stimuli. Groups of men and women performed a free-recall task of words or pictures in which 20 items were presented concurrently and the number of correct items recalled was measured. Following stimulus presentation, half of the participants were presented a verbal-based distraction task. On the verbal working-memory task, performance of men and women was not significantly different in the no-distraction condition. However, in the distraction condition, women's recall was significantly lower than their performance in the no-distraction condition and men's performance in the distraction condition. These findings are consistent with previous research and point to sex differences in cognitive ability putatively resulting from functional neuroanatomical dissimilarities. On the visual working-memory task, women showed significantly greater recall than men. These findings are inconsistent with previous research and underscore the need for further research.     

Verified Hormone Therapy Improves Episodic Memory Performance in Healthy Postmenopausal Women

ABSTRACT

Studies of hormone therapy (HT) and cognition have yielded conflicting results. The aim of this observational study was to examine the effect of estradiol, via serum verified HT (estradiol, estriol, progesterone) and endogenous estradiol, on 108 healthy postmenopausal women's cognitive performance. The results demonstrated that the 43 HT-users performed at a significantly higher level than non-users on episodic memory tasks and on a verbal fluency task, whereas HT-users and non-users did not differ on tasks assessing semantic memory and spatial visualization. In addition, there was a positive relationship between serum estradiol level and episodic memory performance, indicating that postmenopausal HT is associated with enhanced episodic memory and verbal fluency, independent of age and education. These observational results suggest that HT use may be sufficient to exert small, yet positive effects on female sensitive cognitive tasks. Hormone therapy compliance and formulation is discussed as confounding factors in previous research.     

Pupillary responses to pictures and descriptions of sex-stereotyped stimuli

An attempt was made to replicate Hess and Polt's (1960) report of sex differences in pupillary responses to sex-stereotyped pictures. Some methodological refinements were used that seem desirable for future studies. College men and women were either shown or told they would be shown pictures of a semi-nude man, a semi-nude woman, a baby, and a landscape. With resting pupil size as covariate, a three-factor analysis of covariance did not show sex differences in response to visually presented stimuli. Men responded more to verbal than visual mode of presentation and more than women to verbal stimuli. Contrary to previous results, men responded as much or more than women to verbal or visual presentation of baby stimuli. The verbal or anticipatory mode seems to be at least as sensitive as the visual and eliminates problems of control of visual materials.     

Verified hormone therapy improves episodic memory performance in healthy postmenopausal women

Studies of hormone therapy (HT) and cognition have yielded conflicting results. The aim of this observational study was to examine the effect of estradiol, via serum verified HT (estradiol, estriol, progesterone) and endogenous estradiol, on 108 healthy postmenopausal women's cognitive performance. The results demonstrated that the 43 HT-users performed at a significantly higher level than non-users on episodic memory tasks and on a verbal fluency task, whereas HT-users and non-users did not differ on tasks assessing semantic memory and spatial visualization. In addition, there was a positive relationship between serum estradiol level and episodic memory performance, indicating that postmenopausal HT is associated with enhanced episodic memory and verbal fluency, independent of age and education. These observational results suggest that HT use may be sufficient to exert small, yet positive effects on female sensitive cognitive tasks. Hormone therapy compliance and formulation is discussed as confounding factors in previous research.