Alzheimer disease seen through the lens of sex and gender

Laura Castro-Aldrete; Melanie Einsiedler; Julie Novakova Martinkova; Herman Depypere; Ting Fang Alvin Ang; Michelle M Mielke; Shireen Sindi; Harris A Eyre; Rhoda Au; Anne Marie Schumacher Dimech; Anna Dé; Cassandra Szoeke; Maria Carmela Tartaglia; Antonella Santuccione Chadha

doi:10.1038/s41582-025-01071-0

Alzheimer disease seen through the lens of sex and gender

Nat Rev Neurol. 2025 May;21(5):235-249. doi: 10.1038/s41582-025-01071-0. Epub 2025 Apr 14.

Authors

Laura Castro-Aldrete¹, Melanie Einsiedler^#², Julie Novakova Martinkova^#^{2

3}, Herman Depypere⁴, Ting Fang Alvin Ang⁵, Michelle M Mielke⁶, Shireen Sindi^{7

8}, Harris A Eyre^{9

10}, Rhoda Au¹¹, Anne Marie Schumacher Dimech^{2

12}, Anna Dé², Cassandra Szoeke¹³, Maria Carmela Tartaglia^{2

14

15}, Antonella Santuccione Chadha¹⁶

Affiliations

¹ Women's Brain Foundation, Basel, Switzerland. laucas.wbp@gmail.com.
² Women's Brain Foundation, Basel, Switzerland.
³ Memory Clinic, Department of Neurology, Second Faculty of Medicine, Charles University, Motol University Hospital, Prague, Czech Republic.
⁴ Department of Gynecology, Breast and Menopause Clinic, University Hospital, Coupure Menopause Centre, Ghent, Belgium.
⁵ Department of Anatomy and Neurobiology and Slone Center of Epidemiology, Boston University Chobanian and Avedisian School of Medicine, Boston, MA, USA.
⁶ Department of Epidemiology and Prevention, Wake Forest University School of Medicine, Winston-Salem, NC, USA.
⁷ Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden.
⁸ The Ageing Epidemiology Research Unit, School of Public Health, Faculty of Medicine, Imperial College London, London, UK.
⁹ Neuro-Policy Program, Center for Health and Biosciences, The Baker Institute for Public Policy, Rice University, Houston, TX, USA.
¹⁰ Euro-Mediterranean Economists Association, Barcelona, Spain.
¹¹ Department of Anatomy and Neurobiology, Neurology, Medicine and Epidemiology, Boston University Chobanian and Avedisian School of Medicine and School of Public Health, Boston, MA, USA.
¹² Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland.
¹³ The University of Melbourne, Melbourne, Victoria, Australia.
¹⁴ Krembil Brain Institute, University Health Network, Toronto, Ontario, Canada.
¹⁵ Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, Ontario, Canada.
¹⁶ Women's Brain Foundation, Basel, Switzerland. info@womensbrainproject.com.

^# Contributed equally.

PMID: 40229578
DOI: 10.1038/s41582-025-01071-0

Abstract

Alzheimer disease (AD) is a life-limiting neurodegenerative disorder that disproportionately affects women. Indeed, sex and gender are emerging as crucial modifiers of diagnostic and therapeutic pathways in AD. This Review provides an overview of the interactions of sex and gender with important developments in AD and offers insights into priorities for future research to facilitate the development and implementation of personalized approaches in the shifting paradigm of AD care. In particular, this Review focuses on the influence of sex and gender on important advances in the treatment and diagnosis of AD, including disease-modifying therapies, fluid-based biomarkers, cognitive assessment tools and multidomain lifestyle interventional studies.

Publication types

Review

MeSH terms

Alzheimer Disease* / diagnosis
Alzheimer Disease* / epidemiology
Alzheimer Disease* / therapy
Biomarkers
Female
Humans
Male
Sex Characteristics*
Sex Factors

Substances

Biomarkers