Sex differences in documented clinical features of memory clinic patients: A natural language processing study

Abstract

INTRODUCTION: Sex differences in signs and symptoms of cognitive impairment are well described in research cohorts, but whether they are reflected in routine clinical documentation is unknown. METHODS: We applied natural language processing to clinical letters from 915 memory clinic patients in the Utrecht Patient-Oriented Database. Sex differences in documented clinical features were assessed with logistic regression, with and without age adjustment. Benjamini-Hochberg correction was applied for multiple comparisons. RESULTS: We included 1036 clinical letters from 915 patients (47% women; mean age 66 ± 14 vs. 67 ± 13 years, p = 0.6). The most common clinical features were memory problems (56.5% overall) and forgetting intended actions (49.6%). After correction for multiple comparisons, no significant sex differences remained. At the nominal level, women more often had documentation of stress (OR 0.39), headache (OR 0.63), and calendar use for memory support (OR 0.66); men more often had documentation of getting angry easily (OR 1.72) and short-term memory problems (OR 1.70). DISCUSSION: This exploratory study identified suggestive but non-significant sex differences in documented clinical features in memory clinic practice. Differences may reflect variation in occurrence, reporting, or documentation habits, and warrant replication in larger, diagnosis-stratified samples.