4.7 Article

Sex differences in the behavioral variant of frontotemporal dementia: A new window to executive and behavioral reserve

Journal

ALZHEIMERS & DEMENTIA
Volume 17, Issue 8, Pages 1329-1341

Publisher

WILEY
DOI: 10.1002/alz.12299

Keywords

cognitive reserve; diagnosis; frontotemporal dementia; magnetic resonance imaging; neuroimaging; progression; resilience; survival

Funding

  1. Health Department of the Government of Catalonia (grant PERIS) [SLT002/16/00408]
  2. NIH [AG019724, AG032306, AG045390, NS092089, AG045333, AG056749, AG062422, AG061253, AG058752, K24AG053435]
  3. Larry. L. Hillblom Foundation [2018-A-025-FEL, 2017-A-004-FEL, 2014-A-004-NET]
  4. Association for Frontotemporal Degeneration
  5. Fondo de Investigaciones Sanitario (FIS)
  6. Instituto de Salud Carlos III [PI14/01126, PI17/01019, PI13/01532, PI16/01825, PI18/00335, INT19/00016, PI18/00435, PI15/01618, PI14/1561, PI18/00326, AC14/00013, PI17/01896]
  7. CIBERNED program (Program 1, Alzheimer Disease to AL and SIGNAL study, www.signalstudy.es)
  8. Marato TV3 grant [20141210, 044412, 20143810]
  9. Generalitat de Catalunya [2014SGR-0235]
  10. Generalitat de Catalunya (PERIS) [SLT006/17/125, SLT006/17/00119]
  11. BBVA foundation
  12. Fundacio Bancaria La Caixa
  13. Global Brain Health Institute
  14. Rio Hortega grant from Instituto de Salud Carlos III [CM17/00074]
  15. Emili Letang post-residency research grant from Hospital Clinic de Barcelona
  16. Sysley D'Ornano Foundation
  17. Jerome Lejeune Foundation
  18. [R01AG059794]

Ask authors/readers for more resources

The study revealed that women with bvFTD exhibited greater atrophy burden in the frontotemporal regions compared to men, despite having similar clinical characteristics. Additionally, women showed better executive function performance and experienced fewer changes in apathy, sleep, and appetite compared to men at a similar level of atrophy.
Introduction: Biological sex is an increasingly recognized factor driving clinical and structural heterogeneity in Alzheimer's disease, but its role in the behavioral variant of frontotemporal dementia (bvFTD) is unknown. Methods: We included 216 patients with bvFTD and 235 controls with magnetic resonance imaging (MRI) from a large multicenter cohort. We compared the clinical characteristics and cortical thickness between men and women with bvFTD and controls. We followed the residuals approach to study behavioral and cognitive reserve. Results: At diagnosis, women with bvFTD showed greater atrophy burden in the frontotemporal regions compared to men despite similar clinical characteristics. For a similar amount of atrophy, women demonstrated better-than-expected scores on executive function and fewer changes in apathy, sleep, and appetite than men. Discussion: Our findings suggest that women might have greater behavioral and executive reserve than men, and neurodegeneration must be more severe in women to produce symptoms similar in severity to those in men.

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