Sexual differences regarding Alzheimer's disease: a narrative review

Background. Actually, there are about 5.2 million people with Alzheimer's dementia (AD) in the USA, 3.3 million are women and 1.9 million are men. Objective. We will find out the status on the Alzheimer disease in relation to the brain structure, diagnosis, symptoms and therapy by gender. Methods. We analyzed, in this narrative review, the literature between 1989-2019 published on the Pubmed about Alzheimer disease and gender. The keywords were: Alzheimer disease and sex differences. Conclusions. Women over 80 years have a higher incidence of AD than men. Women have a faster age-related decline and are more likely to respond to donepezil and rivastigmina leading to less cognitive decline. At more advanced ages, women incurred greater costs than men of the same age. Woman gender could be a risk factor for evolution of AD. We will emphasize the importance of considering sex as a biological variable in the design of preclinical and clinical studies that investigate underlying pathologies or response to pharmacological interventions in AD