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J Alzheimers Dis. 2019;67(1):35-60. doi: 10.3233/JAD-180213.

Sex Differences in Alzheimer's Disease: Where Do We Stand?

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Behavioral Neuroscience Laboratory, Department of Pharmacology, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil.
Center of Health and Biological Sciences, Universidade Federal Rural do Semiárido, Mossoró, Brazil.


Alzheimer's disease (AD) is a neurodegenerative disorder that drastically compromises patients' and relatives' quality of life, besides being a significant economic burden to global public health. Its pathophysiology is not completely elucidated yet, hence, the current therapies are restricted to treating the symptoms. Over the years, several epidemiological studies have shown disproportionalities in AD when sex is considered, which has encouraged researchers to investigate the potentiality of sex as a risk factor. Studies in rodent models have been used to investigate mechanistic basis of sex differences in AD, as well as the development of possible new sex-specific therapeutic strategies. However, full knowledge on factors related to this sexual dimorphism remains to be unraveled. Some findings point to differences in genetic and developmental backgrounds either earlier in life or in the aging brain. Herein we summarize the multisystemic framework behind the sex differences in AD and discuss the possible mechanisms involved in these differences raised by the literature so far in an integrative perspective.


Aging; animal models; hormones; humans; immune system; oxidative stress; stress


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