To investigate sex differences in Alzheimer pathology and structural brain resilience in a community-based cohort of adults without cognitive impairment.
Key Findings:
Women exhibited higher global amyloid burden than men.
Women had greater tau burden in advanced Braak stages compared to men.
Women showed greater Alzheimer disease signature cortical thickness and lower white matter hyperintensity burden than men.
Sex differences in tau burden were more pronounced among apolipoprotein E epsilon 4 carriers.
Interpretation:
The findings suggest that women may have a unique profile of Alzheimer pathology characterized by higher amyloid and tau levels, alongside structural resilience in certain brain regions.
Limitations:
Cross-sectional design limits causal inference.
Sex determined by self-report may introduce misclassification.
Lack of assessment for gender-related sociocultural factors.
Sample unevenly distributed by sex and racial/ethnic subgroups.
Conclusion:
Further research with larger, more balanced cohorts is needed to explore the intersection of sex, race, and ethnicity in Alzheimer disease outcomes.
