Abstract

The Journal of Alzheimer’s Disease (JAD) is pleased to announce that
Jacob’s pursuit of Alzheimer’s disease research is in honor of his grandfather, Michael Cellere, who passed away in 2025 with early-onset AD.
Importance of published article
The association between female sex and increased risk of Alzheimer’s disease (AD) has been well established. Sex differences have been found at autopsy, neuroimaging, and cerebrospinal fluid outcomes related to AD. However, the mechanisms that cause females to disproportionately experience AD remain unclear.
In an effort to investigate this association, this study examined sex differences on cross-sectional and longitudinal levels of plasma glial fibrillary acidic protein (GFAP), neurofilament light (NfL), phosphorylated tau (p-tau181), and total tau (t-tau) among 567 participants from the Boston University Alzheimer’s Disease Research Center who spanned the diagnostic continuum. We found that females had higher plasma GFAP compared to males at baseline, regardless of cognitive diagnosis. Among those with dementia, females had higher plasma NfL levels compared to males. Plasma NfL selectively predicted accelerated progression of dementia severity in females but not males. There were no significant findings for plasma p-tau181 and t-tau.
This study found distinct sex-related differences in blood-based biomarkers of tau, neuroinflammation, and neuronal injury, providing further insights into the potential pathways by which female sex confers risk for AD. Understanding the mechanisms responsible for these differences is imperative in developing AD biomarkers, diagnostic, and prognostic strategies that can benefit all, including those who have historically been disproportionately affected. The study encourages the need for additional research that incorporates and evaluates biological factors of sex, such as sex hormones, menstrual and reproductive health. Furthermore, there remains a need to establish studies that appropriately distinguish between factors of sex and gender.
Footnotes
Acknowledgements
Statement from the Editor-in-Chief
“Jacob Labonte and coworkers address one of the longest-standing questions in Alzheimer’s disease—why women face greater Alzheimer's disease risk. With exceptional biomarker data they inform and advance the biology of this issue by demonstrating sex-specific patterns in GFAP and NfL. We are very excited to present this award for this important study.” - George Perry, PhD
