학술논문

Sex-dependent autosomal effects on clinical progression of Alzheimer’s disease
Document Type
article
Source
Brain. 143(7)
Subject
Alzheimer's Disease
Neurodegenerative
Brain Disorders
Prevention
Alzheimer's Disease including Alzheimer's Disease Related Dementias (AD/ADRD)
Dementia
Genetics
Acquired Cognitive Impairment
Neurosciences
Aging
Aetiology
2.1 Biological and endogenous factors
Neurological
Aged
Alzheimer Disease
Disease Progression
Female
Genome-Wide Association Study
Genotype
Humans
Male
Middle Aged
Multifactorial Inheritance
Polymorphism
Single Nucleotide
Sex Characteristics
polygenic scores
sex differences
Alzheimer's disease
hazard score
cognitive decline
Medical and Health Sciences
Psychology and Cognitive Sciences
Neurology & Neurosurgery
Language
Abstract
Sex differences in the manifestations of Alzheimer's disease are under intense investigation. Despite the emerging importance of polygenic predictions for Alzheimer's disease, sex-dependent polygenic effects have not been demonstrated. Here, using a sex crossover analysis, we show that sex-dependent autosomal genetic effects on Alzheimer's disease can be revealed by characterizing disease progress via the hazard function. We first performed sex-stratified genome-wide associations, and then applied derived sex-dependent weights to two independent cohorts. Relative to sex-mismatched scores, sex-matched polygenic hazard scores showed significantly stronger associations with age-at-disease-onset, clinical progression, amyloid deposition, neurofibrillary tangles, and composite neuropathological scores, independent of apolipoprotein E. Models without using hazard weights, i.e. polygenic risk scores, showed lower predictive power than polygenic hazard scores with no evidence for sex differences. Our results indicate that revealing sex-dependent genetic architecture requires the consideration of temporal processes of Alzheimer's disease. This has strong implications not only for the genetic underpinning of Alzheimer's disease but also for how we estimate sex-dependent polygenic effects for clinical use.