Women and men exhibit notable differences in Alzheimer disease (AD) risk and resilience, according to data presented at the Alzheimer’s Association International Conference (AAIC) 2019 (14–18 July 2019, Los Angeles, CA, USA).

In one study, Brian Kunkle and colleagues used exome-wide analysis to explore sex differences in genetic risk factors for AD. The investigators found that the genes MCOLN3 and CHMP2B were specifically linked to AD risk in men, whereas the CD1E and PTPRC genes were related to AD risk in women only. “This research demonstrates that genetics may contribute to differences in risk and progression of AD between men and women,” commented Kunkle.

In the early stages of AD, verbal memory is known to be better preserved in women than in men. In a new study reported at AAIC 2019, Erin Sundermann and colleagues used 18F-FDG–PET to identify neuroimaging correlates of this phenomenon. The researchers found that in the presence of moderate levels of amyloid-β deposition, women showed higher levels of brain glucose metabolism than did men, suggesting that the female brain is more resilient to AD-related brain changes at this stage of the disease.

In a third study presented at the conference, Elizabeth Rose Mayeda and co-workers found evidence that social factors can contribute to cognitive resilience in the female population. Specifically, the team observed that participation in the paid workforce during early adulthood and middle age was associated with a reduced rate of cognitive decline in women.

“The majority of people living with AD are women and it’s imperative we understand why,” said the Alzheimer’s Association chief science officer Maria C. Carrillo. “The research reported … at AAIC gets us one step closer to answering that question by identifying specific biological and social reasons why AD is different in men and women.”