Sex differences in Alzheimer's disease blood biomarkers in a Caribbean population of African ancestry: The Tobago Health Study

Author:

Rosano Caterina1ORCID,Karikari Thomas K.23,Cvejkus Ryan1,Bellaver Bruna2,Ferreira Pamela C. L.2,Zmuda Joseph1,Wheeler Victor4,Pascoal Tharick A.5,Miljkovic Iva1

Affiliation:

1. Department of Epidemiology School of Public Health University of Pittsburgh Pittsburgh Pennsylvania USA

2. Department of Psychiatry University of Pittsburgh Pittsburgh Pennsylvania USA

3. Department of Psychiatry and Neurochemistry Institute of Neuroscience and Physiology The Sahlgrenska Academy University of Gothenburg Gothenburg Sweden

4. Tobago Health Studies Office Scarborough Tobago Trinidad and Tobago

5. Department of Neurology School of Medicine University of Pittsburgh Pittsburgh Pennsylvania USA

Abstract

AbstractINTRODUCTIONAlzheimer's disease (AD) is increasing in the Caribbean, especially for persons of African ancestry (PAA) and women. However, studies have mostly utilized surveys without AD biomarkers.METHODSIn the Tobago Health Study (n = 309; 109 women, mean age 70.3 ± 6.6), we assessed sex differences and risk factors for serum levels of phosphorylated tau‐181 (p‐tau181), amyloid‐beta (Aβ)42/40 ratio, glial fibrillary acidic protein (GFAP), and neurofilament light chain (NfL). Blood samples were from 2010 to 2013 for men and from 2019 to 2023 for women.RESULTSWomen were more obese, hypertensive, and sedentary but reported less smoking and alcohol use than men (age‐adjusted p < 0.04). Compared to men, women had worse levels of AD biomarkers, with higher p‐tau181 and lower Aβ42/40, independent of covariates (p < 0.001). In sex‐stratified analyses, higher p‐tau181 was associated with older age in women and with hypertension in men. GFAP and NfL did not differ by sex.DISCUSSIONWomen had worse AD biomarkers than men, unexplained by age, cardiometabolic diseases, or lifestyle. Studying risk factors for AD in PAA is warranted, especially for women earlier in life.

Funder

National Institute of Arthritis and Musculoskeletal and Skin Diseases

National Institute of Diabetes and Digestive and Kidney Diseases

National Heart, Lung, and Blood Institute

National Institute on Aging

Publisher

Wiley

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