The Biological Divergence: Why Sex Matters in Preclinical Alzheimer’s Disease
The epidemiological observation that women are disproportionately affected by Alzheimer’s disease (AD) has long been a subject of intense investigation. While increased longevity in women was once considered the primary driver, emerging evidence suggests that biological sex-specific pathways significantly influence the progression of AD pathology. A pivotal study recently published in JAMA Neurology (2026) by Coughlan et al. provides critical insights into this phenomenon, demonstrating that the relationship between amyloid-β (Aβ) and tau—the two hallmark proteins of AD—is fundamentally different in women compared to men. Understanding these differences is not merely an academic exercise; it is a clinical necessity for improving the accuracy of diagnostics and the efficacy of emerging anti-amyloid and anti-tau therapies.
