ArticleAlzheimer's & dementia : the journal of the Alzheimer's Association2018
Sex, amyloid, and APOE ε4 and risk of cognitive decline in preclinical Alzheimer's disease: Findings from three well-characterized cohorts.
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Article in Alzheimer's & dementia : the journal of the Alzheimer's Association, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 182 papers, 5 of them syntheses that pooled it.
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182citing papers in PubMed, 5 pooled it
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Who cites it
182 citing papers in PubMed, 5 syntheses or guidelines pooled it, 272 citations in OpenAlex.
- Elevated temporal tau PET predicts faster cognitive decline in women than men: A meta-analysis.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2026Pooled it
- Evaluating the Therapeutic Effects of Oxytocin on Animal Model of Alzheimer's Disease: A Systematic Review.Current Alzheimer research · 2025Pooled it
- Association between hyperlipidemia and postoperative delirium risk: a systematic review and meta-analysis.Frontiers in aging neuroscience · 2025Pooled it
- Digital Clock Drawing as an Alzheimer's Disease Susceptibility Biomarker: Associations with Genetic Risk Score and APOE in Older Adults.The journal of prevention of Alzheimer's disease · 2024Pooled it
- Proportion of Women and Reporting of Outcomes by Sex in Clinical Trials for Alzheimer Disease: A Systematic Review and Meta-analysis.JAMA network open · 2021Pooled it
- Sex differences in cognitive resilience in preclinical autosomal-dominant Alzheimer's disease carriers and non-carriers: Baseline findings from the API ADAD Colombia Trial.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2022Trial
- Impact of adjunctive quantitative analysis on visual interpretation of amyloid PET: a multiple tracer, multicentre study.European radiology · 2026Article
- Global and regional amyloid-β in explaining APOE-ε4 and sex associations with medial temporal tau: a neuropathology study.Acta neuropathologica · 2026Article
- Sex-specific regulation of angiogenin in Alzheimer's disease.Molecular psychiatry · 2026Article
- Therapeutic Administration ofInternational journal of molecular sciences · 2026Article
- Sex-Specific Structural Vulnerability in Alzheimer's Disease: Insights from APOE ε 4-Negative Patients.Life (Basel, Switzerland) · 2026Article
- Tau-PET and CSF MTBR-tau243 comparisons validate increased tau aggregation in females.European journal of nuclear medicine and molecular imaging · 2026Article
- Age at menopause,Research square · 2026Article
- Cortical gray-white matter contrast alterations precede amyloid-β positivity and macrostructural changes in older adults without dementia.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2026Article
- Sex differences in brain glucose metabolism and Alzheimer's disease risk and progression.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2026Review
- Sex-specific retina-brain signatures link ERα/ERβ imbalance with gliosis in Alzheimer's disease.bioRxiv : the preprint server for biology · 2026Article
- Sex-specific immune-brain coupling in hippocampal circuits and Alzheimer's disease vulnerability.Research square · 2026Article
- Trajectories of plasma and CSF MTBR-tau243 and phosphorylated-tau species across the Alzheimer's disease continuum.Nature communications · 2026Article
- Elevated plasma klotho levels attenuate Alzheimer's disease pathologies and cognitive decline in APOE ε4 carriers.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2026Article
- Health system patterns of imaging and fluid biomarker testing in the era of anti-amyloid therapies.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2026Article
122 more citing papers are in PubMed but not listed here.
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Authors and funding
28 authors at 15 institutions in 4 countries.
Rachel F BuckleyThe Florey Institute, The University of Melbourne, Victoria, Australia; Melbourne School of Psychological Science, University of Melbourne, Victoria, Australia; Harvard Aging Brain Study, Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA; Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Women's Hospital, Boston, MA, USA. Electronic address: rfbuckley@mgh.harvard.edu.
Elizabeth C MorminoDepartment of Neurology, Stanford University, CA, USA.
Rebecca E AmariglioHarvard Aging Brain Study, Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA; Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Women's Hospital, Boston, MA, USA.
Michael J ProperziHarvard Aging Brain Study, Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
Jennifer S RabinDepartment of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
Yen Ying LimThe Florey Institute, The University of Melbourne, Victoria, Australia.
Kathryn V PappHarvard Aging Brain Study, Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA; Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Women's Hospital, Boston, MA, USA.
Heidi I L JacobsDivision of Nuclear Medicine and Molecular Imaging, Department of Radiology, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA; Faculty of Health, Medicine and Life Sciences, School for Mental Health and Neuroscience, Alzheimer Centre Limburg, Maastricht University, Maastricht, The Netherlands.
Samantha BurnhamThe Australian eHealth Research Centre, CSIRO Health & Biosecurity, Victoria, Australia.
Bernard J HanseeuwHarvard Aging Brain Study, Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA; Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Women's Hospital, Boston, MA, USA; Department of Neurology, Cliniques Universitaires Saint-Luc, Institute of Neuroscience, Université Catholique de Louvain, Brussels, Belgium.
Vincent DoréThe Australian eHealth Research Centre, CSIRO Health & Biosecurity, Queensland, Australia.
Annette DobsonThe University of Queensland, School of Public Health, Faculty of Medicine, Queensland, Australia.
Colin L MastersThe Florey Institute, The University of Melbourne, Victoria, Australia.
Michael WallerThe University of Queensland, School of Public Health, Faculty of Medicine, Queensland, Australia.
Christopher C RoweDepartment of Nuclear Medicine and Centre for PET, Austin Health, Victoria, Australia; Department of Medicine, Austin Health, The University of Melbourne, Victoria, Australia.
Paul MaruffCogstate, Ltd., Australia.
Michael C DonohueDepartment of Neurology, University of Southern California, San Diego, CA, USA.
Dorene M RentzHarvard Aging Brain Study, Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA; Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Women's Hospital, Boston, MA, USA.
Dylan KirnHarvard Aging Brain Study, Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA; Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Women's Hospital, Boston, MA, USA.
Trey HeddenDivision of Nuclear Medicine and Molecular Imaging, Department of Radiology, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA.
Jasmeer ChhatwalHarvard Aging Brain Study, Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
Aaron P SchultzHarvard Aging Brain Study, Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA; Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Women's Hospital, Boston, MA, USA.
Keith A JohnsonDivision of Nuclear Medicine and Molecular Imaging, Department of Radiology, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA.
Victor L VillemagneDepartment of Nuclear Medicine and Centre for PET, Austin Health, Victoria, Australia; Department of Medicine, Austin Health, The University of Melbourne, Victoria, Australia.
Reisa A SperlingHarvard Aging Brain Study, Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA; Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Women's Hospital, Boston, MA, USA.
Alzheimer's Disease Neuroimaging Initiative
Australian Imaging, Biomarker and Lifestyle study of ageing
Harvard Aging Brain Study
Center for Pain and the Brain · USHarvard University · USUniversity of Melbourne · AUBrigham and Women's Hospital · USUniversity of Queensland · AUAustin Health · AUAustralian e-Health Research Centre · AUCliniques Universitaires Saint-Luc · BECSIRO Health and Biosecurity · AUFlorey Institute of Neuroscience and Mental Health · AUMaastricht University · NLMassachusetts General Hospital · USProstate Cancer Foundation of Australia · AUSouthern States University · USStanford University · US
Funding
Project 1U19AG024904 · NIA · NORTHERN CALIFORNIA INSTITUTE/RES/EDU · PI MICHAEL W WEINER · 2016 to 2026
$226.7MAlzheimer's Disease Neuroimaging Initiative - SupplementU01AG024904 · NIA · NORTHERN CALIFORNIA INSTITUTE RES &EDUC · PI WEINER, MICHAEL W · 2004 to 2015
$121.0MTRIAL OF VALPROATE TO ATTENUATE THE PROGRESSION OF ADU01AG010483 · NIA · UNIVERSITY OF ROCHESTER · PI AISEN, PAUL S. · 1991 to 2012
$116.2MRECRUITMENT COREU19AG010483 · NIA · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI FELDMAN, HOWARD · 2013 to 2020
$80.6MImaging CoreU19AG032438 · NIA · WASHINGTON UNIVERSITY · PI BATEMAN, RANDALL J · 2010 to 2025
$53.9MVascular factors, physical activity, and inflammation as modulators of neurodegenerative and cognitive trajectories (Project 2)P01AG036694 · NIA · MASSACHUSETTS GENERAL HOSPITAL · PI Rachel Frances Buckley, Keith A. Johnson · 2010 to 2026
$50.2MTHE ROLE OF ADVANCED CAA IN ALZHEIMER'S DEMENTIAP50AG005134 · NIA · MASSACHUSETTS GENERAL HOSPITAL · PI BETENSKY, REBECCA A. · 1985 to 2018
$42.1MProject 4P41EB015896 · NIBIB · MASSACHUSETTS GENERAL HOSPITAL · PI ROSEN, BRUCE R · 2012 to 2018
$9.8MEvolution of memory-related fMRI activation over the course of MCI and ADR01AG027435 · NIA · BRIGHAM AND WOMEN'S HOSPITAL · PI JOHNSON, KEITH A., SPERLING, REISA A. · 2006 to 2016
$8.6MVascular Dysfunction in Cerebral Amyloid AngiopathyR01AG026484 · NIA · MASSACHUSETTS GENERAL HOSPITAL · PI GREENBERG, STEVEN M · 2005 to 2019
$7.5MImaging CoreU01AG032438 · NIA · WASHINGTON UNIVERSITY · PI BATEMAN, RANDALL J · 2008 to 2009
$6.1MCharacterizing the Evolution of Amyloid Deposition in Normal ElderlyR01AG037497 · NIA · MASSACHUSETTS GENERAL HOSPITAL · PI JOHNSON, KEITH A. · 2010 to 2014
$3.2MNCRR NIH HHS S10 RR021110NCRR NIH HHS S10 RR023043NCRR NIH HHS S10 RR023401NIA NIH HHS K23 AG049087NIA NIH HHS K24 AG035007NIA NIH HHS P01 AG036694NIA NIH HHS P50 AG005134NIA NIH HHS R01 AG026484NIA NIH HHS R01 AG027435NIA NIH HHS R01 AG034556NIA NIH HHS R01 AG037497NIA NIH HHS R21 AG038994NIA NIH HHS U01 AG010483NIA NIH HHS U01 AG024904NIA NIH HHS U01 AG032438NIA NIH HHS U19 AG024904NIA NIH HHS U19 AG032438NIBIB NIH HHS K23 EB019023NIBIB NIH HHS P41 EB015896NIBIB NIH HHS R01 EB014894
Abstract
introductionOur objective was to investigate the effect of sex on cognitive decline within the context of amyloid β (Aβ) burden and apolipoprotein E genotype.
methodsWe analyzed sex-specific effects on Aβ-positron emission tomography, apolipoprotein, and rates of change on the Preclinical Alzheimer Cognitive Composite-5 across three cohorts, such as the Alzheimer's Disease Neuroimaging Initiative, Australian Imaging, Biomarker and Lifestyle, and Harvard Aging Brain Study (n = 755; clinical dementia rating = 0; age (standard deviation) = 73.6 (6.5); female = 55%). Mixed-effects models of cognitive change by sex, Aβ-positron emission tomography, and apolipoprotein ε4 were examined with quadratic time effects over a median of 4 years of follow-up.
resultsApolipoprotein ε4 prevalence and Aβ burden did not differ by sex. Sex did not directly influence cognitive decline. Females with higher Aβ exhibited faster decline than males. Post hoc contrasts suggested that females who were Aβ and apolipoprotein ε4 positive declined faster than their male counterparts. DISCUSSION: Although Aβ did not differ by sex, cognitive decline was greater in females with higher Aβ. Our findings suggest that sex may play a modifying role on risk of Alzheimer's disease-related cognitive decline.
Indexed as
AgedAged, 80 and overAlzheimer DiseaseAmyloid beta-PeptidesApolipoprotein E4BrainCognitive DysfunctionCohort StudiesDisease ProgressionFemaleHumansMaleProdromal SymptomsRisk FactorsSex FactorsAmyloid beta-PeptidesApolipoprotein E4AmyloidAPOECognitive declineGenderPreclinical Alzheimer's diseaseSex
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