Sex Differences in Alzheimer Disease Imaging Biomarkers in a Diverse, Community-Based Cohort

Do sex differences exist across the pathological constructs of Alzheimer disease (AD) in the seventh decade of life?In this cross-sectional study of 503 Hispanic, non-Hispanic Black, and non-Hispanic White adults without cognitive impairment, women had significantly higher brain amyloid burden and tau burden in Braak stages III through VI, alongside greater cortical thickness in regions affected early in AD, compared with men. These findings were independent of age, educational level, race and ethnicity, ε4 status, and vascular health–related risk factors.These results suggest that women have greater AD pathology yet demonstrate better preserved structural brain integrity compared with men aged in their 60s.

Corresponding Author: José A. Luchsinger, MD, MPH, Columbia University Irving Medical Center, 622 W 168th St, PH-9, New York, NY 10032 (jal94@cumc.columbia.edu).

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