ArticleAlzheimer's & dementia : the journal of the Alzheimer's Association2026
Sex differences in dementia pathology and cognitive performance in a population-based, ethnically diverse Brazilian autopsy study.
Article in Alzheimer's & dementia : the journal of the Alzheimer's Association, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionSex differences in dementia-related neuropathology are understudied in diverse populations.
methodsWe analyzed sex differences in neuropathological and cognitive data from the Brazilian Biobank for Aging Studies. Cognitive performance was evaluated with the Clinical Dementia Rating-Sum of Boxes (CDR-SOB). Linear and logistic regression models were conducted, including interaction terms for age, race, and education.
resultsIn 2229 participants (50.7% female, mean age ± SD 75.4 ± 12.3 years, 62.1% White), female sex was associated with a higher odds of AD pathology (Braak: odds ratio [OR] = 1.42, 95% confidence interval [CI] = 1.17-1.72; Consortium to Establish a Registry for Alzheimer's Disease (CERAD): OR = 1.58, 95% CI = 1.27-1.98), and trans-activation response (TAR) DNA-binding protein 43 (TDP-43) (OR = 1.77, IC 95% = 1.22-2.59), and lower odds of Lewy body disease (OR = 0.69, 95% CI = 0.51-0.95). Female participant had worse cognitive performance (β = 1.56, 95% CI = 1.03-2.10). Sex modified associations of Braak, CERAD, TDP-43, and cerebral amyloid angiopathy with cognition. Age also interacted with sex and pathology on CDR-SOB. DISCUSSION: Sex differences in the associations between sex and neuropathology suggest the need for sex-informed dementia research.
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