Men with Alzheimer's are misdiagnosed more often than women

by Jacksonville.com:

Men with Alzheimer’s disease are more likely to be misdiagnosed than women, researchers at the Mayo Clinic in Jacksonville found in a study of 1,606 brains donated by individuals who ranged in age from 37 to 102.

The results of the study, which found other significant differences in how Alzheimer’s affects men and women, were presented Tuesday during the Alzheimer’s Association International Conference 2016 in Toronto by presenting author Melissa E. Murray, an assistant professor of neuroscience at the Mayo Clinic in Jacksonville.

“While it is well accepted that age is the strongest risk factor for Alzheimer’s, there is an enormous need to understand additional factors that contribute to the development of the disease,” Murray said. “ ... Our study advances our understanding of how age and sex interact with respect to vulnerability to Alzheimer’s.”

Thirty-four percent of the men with Alzheimer’s who donated their brains to the State of Florida brain bank were inaccurately diagnosed, researchers found. Only 22 percent of women with Alzheimer’s were misdiagnosed. Researchers were able to identify the donated brains as having come from people Alzheimer’s because of the presence of the tau and amyloid proteins found in the brain of someone with Alzheimer’s.

The researchers also found that Alzheimer’s begins to develop at a younger age in men than in women, with a spike in the onset of Alzheimer’s in their 60s for men while women more commonly are first affected in their 70s, 80s and 90s. The disease also appears to progress more rapidly in men.

It also tends to affect different parts of the brain in men and women. In women, the disease occurred far more often in the limbic area of the brain which includes the hippocampus, which coordinates memory. In men the disease usually occurs in a different part of the brain, which means memory loss is a symptom found less often in men. That difference may account for the higher rate of misdiagnosis in men, Murray said.

Although memory loss is a symptom most people associate with Alzheimer’s, the disease can affect people in a variety of ways including language impairment, motor disfunction, behavioral issues and apathy, Murray said.

“These patients, their disease has not read the textbooks,” she said.

The earlier onset of Alzheimer’s in men and the higher level of misdiagnosis may mean that the gap between the number of men with Alzheimer’s and the number of women with Alzheimer’s is narrower than current estimates suggest, Murray said.

Currently there are 5.2 million Americans 65 or older diagnosed who have been diagnosed with Alzheimer’s and nearly two-thirds — 3.3 million are women. Of the 1,606 brains in the study, 54 percent were women and 46 percent were men.

Murray, a 2002 graduate of the University of North Florida who earned her doctorate in the neurobiology of disease from the Mayo Clinic, said her next study will focus on whether there is a genetic factor leading to the onset of Alzheimer’s.

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