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Basic Science and Pathogenesis.

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Summary

Women exhibit poorer cognitive function and a higher prevalence of Alzheimer's disease neuropathological changes (ADNC) and co-pathologies compared to men. This highlights significant sex differences in brain aging and dementia risk.

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Area of Science:

  • Neurology
  • Neuroscience
  • Pathology

Background:

  • Investigated sex differences in Alzheimer's disease neuropathological changes (ADNC).
  • Limited research on multiple co-pathological changes.
  • Examined sex differences in AD neuropathology, co-pathology, and cognition in a diverse sample.

Purpose of the Study:

  • To examine sex differences in AD neuropathology.
  • To investigate sex differences in co-pathology.
  • To analyze sex differences in cognitive abilities.

Main Methods:

  • Utilized data from the Biobank for Aging Studies, a population-based autopsy study in Brazil.
  • Assessed AD pathology, TDP-43, Lewy body pathology, infarcts, arteriolosclerosis, and cerebral amyloid angiopathy.
  • Evaluated cognitive abilities using the Clinical Dementia Rating Sum of Boxes (CDR-SOB) and employed regression analyses adjusted for sociodemographic and clinical variables.

Main Results:

  • Women (n=387) had poorer cognitive abilities (CDR-SOB) than men (n=324).
  • Women showed a significantly higher frequency of AD pathology and co-pathologies (p < 0.001).
  • Poorer cognitive abilities in women were linked to the number of co-pathologies associated with ADNC, even after adjustments.

Conclusions:

  • Women experienced poorer cognitive abilities compared to men.
  • Women exhibited a higher association of AD neuropathological changes (ADNC) and co-pathologies.
  • Findings underscore significant sex-based disparities in brain aging and dementia risk.