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Sex, Gender and Pathology

Female sex, among many other risk factors in dementias, has been associated with an increased risk of the development of AD. 

Barnes et al (2004) used data from 141 older Catholic clergy members to assess clinico-pathological correlation between two sexes [1].  The subjects in the study underwent an annual examination and a brain autopsy at death.  Their results showed that:

  • women tended to have more global AD pathology and neurofibrillary tangles but the same amount of neuritic plaques [1]

  • the relation of global AD pathology to clinical diagnosis differed between men and women as each additional unit of AD pathology was associated with a three fold increase in odds of clincial AD in men compared to 20 fold increase in odds of clinical AD in women [1]

  • hence, this data suggests that AD pathology is more likely to be clinically expressed as dementia in women than in men [1]

Further research needs to be conducted to look at pathology in other dementia sub-types.  New methods need to be developed that are sensitive in diagnosing pathological gender differences early on in the disease process to allow for intervention and maximize quality of life.

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S. Goodwin, Division of Clinical and Functional Anatomy, University of Ottawa
 

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1. Barnes LL, Wilson RS, Bienias JL, Schneider JA, Evans DA, Bennett DA. Gender differences in the clinical manisfestations of Alzheimer's Disease pathology. Neurobiol Aging 2004; 25 Suppl 2:S314-15.

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