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us observe brain atrophy. After 1,368 MRI scans, a   environments may be the key to unraveling broad
            study demonstrated that brain atrophic rates were   sex differences in AD.
            about 1-1.5% faster in  females  than  males.   The
                                                     [6]
            levels of Aβ  and tau protein in CSF are promising   Financial support and sponsorship
                       42
            biomarkers of AD. Although by now, there is no    Nil.
            remarkable evidence suggesting sex differences in
            Aβ  and tau levels in CSF, Koran’s study showed   Conflicts of interest
               42
            that associations between Aβ  and tau levels in   There are no conflicts of interest.
                                        42
            CSF and brain atrophy in MRI were sex-specific. A
            total of 348 normal control, 565 patients with MCI   REFERENCES
            and 185 patients with AD from Alzheimer’s disease   1.   Koran ME, Wagener M, Hohman TJ. Sex differences in the
            neuroimaging initiative were included in this study.   association between AD biomarkers and cognitive decline.
            Participants were followed  for an average of 2.5     Brain Imaging Behav 2016; Doi: 10.1007/s11682-016-9523-8.
            years. A significant interaction between sex and CSF   2.   Jia J, Wang F, Wei C, Zhou A, Jia X, Li F, Tang M, Chu L, Zhou
            Aβ  levels was found on longitudinal hippocampal      Y, Zhou C, Cui Y, Wang Q, Wang W, Yin P, Hu N, Zuo X, Song
                                                                  H, Qin W, Wu L, Li D, Jia L, Song J, Han Y, Xing Y, Yang P, Li
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            atrophy and longitudinal decline in memory and        Y, Qiao Y, Tang Y, Lv J, Dong X. The prevalence of dementia in
            executive function. A similar interaction between     urban and rural areas of China. Alzheimers Dement 2014;10:1-9.
            sex and CSF tau levels was also observed. With the   3.   Mielke MM, Vemuri P, Rocca WA. Clinical epidemiology of
                                                                  Alzheimer’s disease: assessing sex and gender differences. Clin
            decrease of CSF Aβ levels or increase of tau levels,   Epidemiol 2014;6:37-48.
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            females showed faster hippocampal atrophy and     4.   Li JQ, Tan L, Wang HF, Tan MS, Tan L, Xu W, Zhao QF, Wang
            cognitive decline compared with males. This result    J, Jiang T, Yu JT. Risk factors for predicting progression from
                                                                  mild cognitive impairment to Alzheimer’s disease: a systematic
            was not modified by different diagnosis.              review and meta-analysis of cohort studies. J Neurol Neurosurg
                                                                  Psychiatry 2016;87:476-84.
            The authors pointed out in discussion that the    5.   Barnes LL, Wilson RS, Bienias JL, Schneider JA, Evans DA,
            result could be explained by age-related changes      Bennett DA. Sex differences in the clinical manifestations of
                                                                  Alzheimer disease pathology.  Arch  Gen  Psychiatry 2005;
            in estrogen levels. Actually, the decline of estrogen   62:685-691.
            levels after menopause is only one of the reasons   6.   Hua X, Hibar D P, Lee S, Toga AW, Jack CR Jr, Weiner MW,
            that are related to sex differences in AD. The        Thompson PM. Sex and age differences in atrophic rates:
                                                                  an ADNI study with  n = 1368 MRI scans.  Neurobiol Aging
            interaction  between  genes,  hormones  and  social   2010;31:1463-80.








































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