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Publications

Journal Article Ppublish

PubMed: 42503573 DOI: 10.1002/alz.71691

Sex differences in dementia pathology and cognitive performance in a population-based, ethnically diverse Brazilian autopsy study.

Alzheimers Dement 22(7):e71691

Authors: Karen Luiza Ramos Socher, Naomi Vidal Ferreira, Vitor Ribeiro Paes, Alberto Fernando Oliveira Justo, Roberta Diehl Rodriguez, Caroline Matos Silva, Renata Elaine Paraizo Leite, Raul Reis Ururahy, Filipe Oto Cunha de Moraes, Ines Liguori Padrão, Eduardo Ferriolli, Carlos Alberto Pasqualucci, Ricardo Nitrini, Lea Tenenholz Grinberg, Sonia Maria Dozzi Brucki, Claudia Kimie Suemoto

Affiliations

  • Cognitive and Behavioral Neurology Unit, Department of Neurology, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.
  • Physiopathology in Laboratory (LIM-22), Department of Pathology, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.
  • Physiopathology in Laboratory (LIM-22), Department of Pathology, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil. Division of Geriatrics, Faculdade de Medicina, Universidade de São Paulo, São Paulo, São Paulo, Brazil.
  • Laboratory Magnetic Resonance Field and Neuroradiology (LIM-44), Department of Radiology, Faculdade de Medicina, Universidade de São Paulo, São Paulo, São Paulo, Brazil.
  • Division of Geriatrics, Faculdade de Medicina, Universidade de São Paulo, São Paulo, São Paulo, Brazil.
  • Laboratory Medicine and Pathology, Mayo Clinic, Jacksonville, Florida, USA.

Abstract

INTRODUCTION

Sex differences in dementia-related neuropathology are understudied in diverse populations.

METHODS

We 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.

RESULTS

In 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.

MeSH

Dementia, Alzheimer Disease, Pathology, Sex Characteristics, Sex, Neuropathology, Autopsy, Sex Differences