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Abstract Details

Sex Differences for Alzheimer's Pathology Association with Dementia Severity in Lewy Body Dementia
Aging, Dementia, and Behavioral Neurology
Aging and Dementia Posters (7:00 AM-5:00 PM)
077

To investigate sex differences for the impact of Alzheimer's disease (AD) pathology on cognition in pathologically-confirmed Lewy body dementia (LBD).
LBD is the second most common neurodegenerative dementia and has high clinical heterogeneity. This heterogeneity is in part due to frequent neuropathological co-pathologies, including Alzheimer's pathology. While there are sex differences for Alzheimer's pathology’s association with cognition in AD, such sex differences have not been investigated in LBD. 
Data was obtained from the National Alzheimer’s Coordinating Center Uniform Data Set (UDS) and Neuropathology Data Set. UDS visits were conducted between September 2005 and August 2019 at 39 AD Research Centers. Individuals with a clinical LBD diagnosis and pathologically-validated limbic or neocortical Lewy body (LB) pathology were included (68 women, 211 men). To avoid findings being skewed by the higher ratio of men in the sample, analysis were performed with a subsample of 68 women and 68 men matched for education, age at last visit and death. The association between AD neuropathological change (NIA-AA none, low/Braak tau 0-II=1; NIA-AA intermediate/Braak tau III-IV=2; NIA-AA high/Braak tau V-VI=3) and dementia severity at last visit (CDR® Dementia Staging Instrument-Sum of Boxes [CDR-SOB]) was assessed.
In the matched subsample, similar rates of men (44.1%) and women (42.6%) had a comorbid clinical AD diagnosis. LB and AD-pathology staging were similar for men (91.2% with neocortical LB, 33.8% with high AD-pathology) and women (94.1% with neocortical LB, 44.1% with high AD-pathology). Women had more higher CDR-SOB scores than men (p=.049). Worse AD pathology was associated with more severe dementia (B=1.21, p=.039), and sex-stratified models showed that this association was significant only for women (B=1.95, p=.018 for women, p=.69 for men). 
In LBD, sex affects the association between AD pathology and dementia severity. Clarifiying the mechanisms behind this association, particularly in women, can guide future precision medicine efforts. 
Authors/Disclosures
Ece Bayram, MD, PhD
PRESENTER 		The institution of Dr. Bayram has received research support from National Institute on Aging (K99AG073453). The institution of Dr. Bayram has received research support from Lewy Body Dementia Association. The institution of Dr. Bayram has received research support from National Institute of Neurological Disorders and Stroke.
David G. Coughlin, MD (University of California San Diego) Dr. Coughlin has received personal compensation in the range of $500-$4,999 for serving as a Consultant for M3 Global Research. The institution of Dr. Coughlin has received research support from Â鶹´«Ã½Ó³»­. The institution of Dr. Coughlin has received research support from NIA. The institution of Dr. Coughlin has received research support from NINDS.
Irene Litvan, MD, FÂ鶹´«Ã½Ó³»­ (UC San Diego Parkinson and Other Movement Disorder Center) Dr. Litvan has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Aprinoia. Dr. Litvan has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Lundbeck. Dr. Litvan has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Frontiers in Neurology. Dr. Litvan has received personal compensation in the range of $50,000-$99,999 for serving as a Chief Editor with Frontiers in Neurology.