GENDER DIFFERENCES ON A BRIEF MEASURE OF COGNITIVE-FUNCTIONING IN ALZHEIMERS-DISEASE

Objective.-We evaluated scores on a brief psychometric screening instr ument-the Mini-Mental State Examination (MMSE)-for possible effects of gender, hypothesizing that women with Alzheimer's disease (AD) would perform more poorly than men. A significant gender difference was to b e explored with post hoc item analyses. Design.-Case-study design. A h ierarchical regression procedure controlled for the possible influence on MMSE performance of demographic variables (eg, age, duration of de mentia symptoms, education, and family history of dementia) before the effect of gender was analyzed. Setting-Data were gathered by trained neuropsychological examiners from subjects enrolled in the Alzheimer's Disease Research Center at the University of Southern California, Los Angeles. Subjects.-One hundred forty-two subjects who met strict crit eria for probable AD and 121 nondemented elderly subjects were include d in the study. All subjects underwent periodic neuropsychological tes ting. We extracted MMSE scores and demographic data to test the hypoth esis that women would perform more poorly than men on the MMSE. Criter ion Measure.-The MMSE was chosen because of its wide use in clinical a nd research settings to screen for the presence or severity of dementi a. Results.-After controlling for the demographic variables for subjec ts with AD, we observed a significant difference in the predicted dire ction for total MMSE score, but there was no significant gender effect on the MMSE for the nondemented elderly sample. Among subjects with A D, gender-associated differences were limited to only a subset of MMSE items. Conclusions.-Results imply that MMSE performance may differ be tween men and women with AD and that differences might pertain only to discrete areas of cognitive functioning. Although gender effects were relatively small, findings indicate the relevance of gender to studie s of AD.