Medical Comorbidities in Alzheimer's Disease: An Autopsy Confirmed Study with a Focus on Sex-Differences?

Objective: Systemic comorbidities are common in Alzheimer's disease (AD) and may influence disease progression, severity, and management. Aim of the study was to assess the prevalence of comorbid medical conditions in a large cohort of AD patients, focusing on sex differences. Method: AD patients from the NIMH Alzheimer Disease Genetics Initiative were enrolled. Data on multimorbidity, demographics, disease characteristics, and clinical assessments were collected from interviews, medical records, and examinations. Univariate and multivariate logistic regression models were performed to identify possible associations between comorbidities and sex. Subgroup analysis was performed for patients with autopsy-confirmed AD. Results: Four hundred and twenty-four AD patients (295 women; mean age: 78.4±8.3 years) were included. Men had a higher prevalence of heart disease, diabetes, chronic obstructive pulmonary disease and smoking, whereas thyroid disease, hypertension and depression were more common in women (all p<0.05). Except for hypertension, all associations found in the univariate analysis were confirmed in the multivariate analysis after adjustment for age. Subgroup analysis of autopsy-confirmed cases confirmed these findings. Conclusions: Our findings support the importance of considering sex-specific comorbidities in AD for precision medicine and emphasize the need for comprehensive assessment of comorbidities to improve clinical outcomes, treatment strategies and health equity.nt.