MW Alzheimer's affects men and women's brains differently, new research shows. What it could mean for testing and care.
By Jessica Hall
'A move away from a one-size-fits-all framework for Alzheimer's disease'
There are 7.2 million people 65 and older with Alzheimer's in the United States, according to the Alzheimer's Association.
Alzheimer's doesn't affect men and women the same, progressing differently by gender, which could lead to differences in clinical care.
Doctors may also need to interpret common Alzheimer's tests differently for each sex, according to new Georgia State research, published in the journal Brain Communications.
"Women have a different trajectory in how the disease will progress," said Mukesh Dhamala, the study's senior author and a professor of physics and neuroscience at Georgia State. "This needs to be implemented and incorporated into care, recognizing that there are differences."
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Of the 7.2 million people 65 and older with Alzheimer's in the United States, 4.4 million are women, according to the Alzheimer's Association. Alzheimer's is fatal and there is no cure.
Women in their 60s are about twice as likely to develop Alzheimer's during the rest of their lives as they are to develop breast cancer, according to the Alzheimer's Association. A woman's estimated lifetime risk of developing Alzheimer's at age 65 is one in five, according to the association.
The new research looked at standard screening tools like the 30-point Mini-Mental State Examination, or MMSE. During the intermediate stage between normal aging and Alzheimer's disease - the stage known as mild cognitive impairment $(MCI)$ - women may score well on the MMSE test. A good score here, however, may not fully reflect underlying brain changes that are happening.
"A woman who scores well on the MMSE in the MCI stage may still be showing underlying brain changes that are not fully captured by that score alone," Dhamala said. "Screening tools may need sex-calibrated interpretation."
Men and women are given the same tests for Alzheimer's, with no adjustments for sex. That may mask differences in how far the disease has progressed in the brain, Dhamala said.
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The research team analyzed brain scans from 332 people at different stages of the disease. In men, the brain showed more shrinkage earlier in the disease's progression - from normal cognitive health to mild cognitive impairment. In women, the brain showed steeper and more widespread changes from the intermediate stage of MCI to Alzheimer's disease.
The findings suggest the brain may be compensating in women in ways that help maintain cognitive performance earlier in the disease. Their cognitive scores were tied to a broader range of brain regions than men's, suggesting the brain may be recruiting additional areas to support performance.
That may help explain why structural brain changes and cognitive scores may not align in the same way for women and men.
The work lays a foundation for the next phase of research, including tracking patients over time and examining how hormones and genetics influence these differences, Dhamala said. More longitudinal studies will be needed to build on the research, but could eventually lead to different tests and treatment options for men and women.
"The larger impact would be a move away from a one-size-fits-all framework for Alzheimer's disease," Dhamala said. "The long-term hope is that findings like ours will lead to sex-specific screening windows and earlier, more precise interventions."
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-Jessica Hall
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April 13, 2026 12:12 ET (16:12 GMT)
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