Women and AD Biomarkers

Research on Alzheimer’s Disease (AD) has demonstrated the importance of earlier intervention (Jack et al., 2024), pushing development of methods to detect AD before memory problems develop. Researchers are examining AD biomarkers found in blood, including amyloid beta 42/40 ((A-beta)42/40), phosphorylated tau 217 (p-tau217), and glial fibrillary acidic protein (GFAP), each of which correlate with the accumulation of protein amyloid beta found in the brain in AD (Schindler et al., 2024, Pereira et al., 2021). The ratio of these markers (p-tau217/ A-beta42) has also proven helpful as it is a good predictor of disease progression (Wang et al., 2025). However, research into the sex differences between these biomarkers is limited, despite the well-known fact that women are twice as likely to develop AD compared to men. Sex-specific research that does exist regarding these differences has shown mixed results, demonstrating a need for more studies pursuing the topic. Understanding sex differences in AD biomarkers may influence earlier detection and treatment of AD. In a study conducted by Dr. Marta Milà-Alomà and colleagues at UC San Francisco, UC Berkeley, and the University of Pennsylvania Perelman School of Medicine, researchers sought to determine the impact of sex on biomarker levels, their accuracy in diagnosing patients, and their ability to determine AD progression.

In this study, Milà-Alomà et al. gathered data from participants, including blood plasma levels of markers A-beta42, A-beta40, p-tau217, and GFAP, amyloid-PET imaging studies, and cognitive assessments. Initial cognitive tests were used to separate participants into two groups: cognitively unimpaired (CU) and cognitively impaired (CI). For each of those groups, the researchers analyzed the data to determine impact of sex on the relationship between the biomarkers, particularly their ability to diagnose AD and their relationship with disease progression.

The findings of this study were complicated, with very different findings depending on whether the participants belonged to the CU or CI groups. Notably, the study did find that plasma biomarkers were influenced by sex as well as the stage of AD. However, regarding the accuracy of biomarkers in diagnosing patients with AD, they also found that changing diagnostic cutoffs (the amount of a biomarker needed to diagnose someone with AD) of these biomarkers based on sex would not be beneficial for better diagnosing men or women with AD. Lastly, this study did find that in CU individuals, biomarkers were better able to detect risk for AD in women than men. In CI individuals, this difference was diminished- biomarkers predicted cognitive decline and disease progression similarly in men and women. While the results of this study might not change how biomarkers are used for diagnosis, they do demonstrate potential to allow for earlier detection of AD risk in women, which might further inform detection and treatment of AD in the future.

Article of Interest:

Milà-Alomà M, Hausle I, Myoraku A, et al. Sex differences in Alzheimer's disease plasma biomarker levels and clinical utility. Alzheimers Dement. 2026;22(2):e71244. doi:10.1002/alz.71244