Sex-driven modifiers of Alzheimer risk: A multimodality brain imaging study
Rahman A, Schelbaum E, Hoffman K, Diaz I, Hristov H, Andrews R, Jett S, Jackson H et al.. Neurology, 2020-06-24
Topic: Amyloid, tau and blood-test diagnosis
Objective To investigate sex differences in late-onset Alzheimer disease (AD) risks by means of multimodality brain biomarkers (β-amyloid load via 11 C-Pittsburgh compound B [PiB] PET, neurodegeneration via 18 F-fluorodeoxyglucose [FDG] PET and structural MRI). Methods We examined 121 cognitively normal participants (85 women and 36 men) 40 to 65 years of age with clinical, laboratory, neuropsychological, lifestyle, MRI, FDG- and PiB-PET examinations. Several clinical (e.g., age, education, APOE status, family history), medical (e.g., depression, diabetes mellitus, hyperlipidemia), hormonal (e.g., thyroid disease, menopause), and lifestyle AD risk factors (e.g., smoking, diet, exercise, intellectual activity) were assessed. Statistical parametric mapping and least absolute shrinkage and selection operator regressions were used to compare AD biomarkers between men and women and to identify the risk factors associated with sex-related differences. Results Groups were comparable on clinical and cognitive measures. After adjustment for each modality-specific confounders, the female group showed higher PiB β-amyloid deposition, lower FDG glucose metabolism, and lower MRI gray and white matter volumes compared to the male group ( p Conclusion Hormonal risk factors, in particular menopause, predict AD endophenotype in middle-aged women. These findings suggest that the window of opportunity for AD preventive interventions in women is early in the endocrine aging process.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Rahman, A., Schelbaum, E., Hoffman, K., Diaz, I., Hristov, H., Andrews, R., et al. (2020). Sex-driven modifiers of Alzheimer risk: A multimodality brain imaging study. Neurology. https://doi.org/10.1212/wnl.0000000000009781
Vancouver
Rahman A, Schelbaum E, Hoffman K, Diaz I, Hristov H, Andrews R, et al. Sex-driven modifiers of Alzheimer risk: A multimodality brain imaging study. Neurology. 2020. doi:10.1212/wnl.0000000000009781. PMID: 32580974.
BibTeX
@article{rahman2020-32580974,
author = {Rahman, A. and Schelbaum, E. and Hoffman, K. and Diaz, I. and Hristov, H. and Andrews, R. and Jett, S. and Jackson, H. and others},
title = {{Sex-driven modifiers of Alzheimer risk: A multimodality brain imaging study}},
journal = {Neurology},
year = {2020},
doi = {10.1212/wnl.0000000000009781},
pmid = {32580974},
url = {https://doi.org/10.1212/wnl.0000000000009781}
}
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Key findings
- Statistical parametric mapping and least absolute shrinkage and selection operator regressions were used to compare AD biomarkers between men and women and to identify the risk factors associated with sex-related differences.
- Results Groups were comparable on clinical and cognitive measures.
- After adjustment for each modality-specific confounders, the female group showed higher PiB β-amyloid deposition, lower FDG glucose metabolism, and lower MRI gray and white matter volumes compared to the male group ( p < 0.05, family-wise error corrected for multiple comparisons).
- These findings suggest that the window of opportunity for AD preventive interventions in women is early in the endocrine aging process.
Why it matters
In 121 cognitively normal middle-aged adults, women showed higher amyloid deposition, lower glucose metabolism, and lower gray and white matter volumes than men, and hormonal factors such as menopause predicted these patterns. This suggests a possible window of opportunity for prevention in women but does not test any treatment or prevention.
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Study details
- Evidence strengthLow
How this study scored 53/100
Published in a leading specialty journal. Scored zero for study design, sample size, effect reported, studied in people and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 9 / 10 | Tier 2 — leading specialty journal (Neurology) |
| Journal's citation record | 4 / 4 | Neurology: journal h-index 525 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 2 / 5 | 2020 — within 10 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 5 / 7 | Cited 163 times (OpenAlex, 2026-10-10) |
| Citations per year | 4 / 5 | 20.4 citations a year over 8 year(s) since 2020 |
| Impact for its field and year | 4 / 6 | Cited 13.8× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 2 / 6 | Cited by 8 other studies in this library |
| Still being cited | 3 / 4 | Cited 77 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 3 / 4 | Last-listed author Lisa Mosconi: h-index 67 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | Cornell University: institution h-index 1,649 (OpenAlex) |
| Multi-centre collaboration | 2 / 3 | OpenAlex lists 4 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 32580974) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 53 / 100 | — |
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Read the original
- DOI: 10.1212/wnl.0000000000009781
- PubMed: 32580974
- Original source →
- Free full text: PubMed Central →
Full text: free to read — PubMed Central lists this copy as free to read: the link above (checked 10 Oct 2026).
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