性別差異及教育程度對語文記憶的影響：從健康老化至失智症患者之文獻綜述

Abstract

過去研究指出，在正常老化的過程中，女性和高教育程度者（相較於男性及低教育程度者）通常在語文記憶具備優勢，然而，隨著輕度認知功能障礙與阿茲海默氏症的疾病進展，這些優勢是否能持續存在，目前尚無定論。其中，在不同國家中的教育機會可能存在差異，並對女性在語文記憶方面的優勢產生顯著影響，但對此議題的相關研究甚少。因此，本綜述旨在探討正常老化和疾病階段中，性別差異、教育程度，以及其交互作用對語文記憶的影響。本文透過 PubMed 和 PsycINFO 資料庫進行文獻搜索，共篩選出17篇相關研究。結果顯示，多數研究表明女性和高教育程度者往往表現出語文記憶方面的優勢，然隨著疾病進展，優勢可能會逐漸減弱。雖然性別和教育程度並不會影響正常老化過程中語文記憶的衰退速度，但在輕度認知功能障礙或阿茲海默氏症患者中，女性和高教育程度者的語文記憶可能會出現更快的衰退。此外，教育對於教育程度較低的年長女性，在語文記憶上具有更大的益處，但對於教育程度較高者則不然，且教育對年長女性的益處在阿茲海默氏症患者上似乎不會持續存在。最後，無論在正常老化或阿茲海默氏症患者中，教育程度似乎並不會影響男性及女性在語文記憶的衰退速度。綜上所述，此研究揭示了性別、教育和語文記憶之間複雜的交互作用，並歸納發現教育程度對年長女性能否能展現語文記憶的優勢可能存在一個閾值，為臨床實務和未來研究提供重要參考。

Verbal memory advantages observed in females and those with higher educational attainment are widely reported during normal aging but whether these advantages persist as mild cognitive impairment (MCI) and Alzheimer's disease (AD) progress remains. Regional disparities in educational opportunities significantly influence these dynamics but have received little attention. This review provides a comprehensive examination of sex differences, the impact of education, and their potential interactions on verbal memory across aging and disease stages. We searched PubMed and PsycINFO databases for cross-sectional and longitudinal studies encompassing cognitively normal individuals, those with MCI, and those diagnosed with AD, identifying a total of 17 relevant studies. The majority of these studies indicate that females and individuals with higher education tend to demonstrate verbal memory advantages, but these advantages may diminish as the disease advances. Despite neither sex nor education influencing age-related verbal memory decline over time, paradoxically, women and higher education levels might decline faster in patients with MCI or AD. Evidence suggests that education confers greater benefits to women’s verbal memory with lower educational attainment but not to those with relatively higher education levels. However, these benefits do not appear to persist in individuals who develop AD, despite the need for further investigation. Furthermore, education does not seem to influence the trajectory of verbal memory decline over time in either sex, whether during normal aging or in individuals with AD. The literature underscores the intricate interplay between sex, education, and verbal memory, suggesting the existence of a potential threshold that may determine the presence of verbal memory advantages in women.