Introduction Sex differences in dementia with Lewy bodies (DLB) have been reported in clinically defined cohorts; however, clinical diagnostic accuracy in DLB is suboptimal and phenotypic differences have not been assessed in pathologically confirmed participants.
Methods Core DLB features were compared across 55 women and 156 men with pathologically defined DLB in the National Alzheimer’s Coordinating Center. These analyses were repeated for 55 women and 55 men matched for age, education and tau burden.
Results In the total sample, women died older, had fewer years of education, had higher tau burden but were less likely to be diagnosed with dementia and clinical DLB. In the matched sample, visual hallucinations continued to be less common in women, and fewer women met clinical DLB criteria.
Discussion Sex impacts clinical manifestations of underlying pathologies in DLB. Despite similar underlying Lewy body pathology, women are less likely to manifest core DLB features and may be clinically underdiagnosed.
Data availability statement
Data may be obtained from a third party and are not publicly available. The data were made available to the authors by the NACC database and may be obtained following the approval of a data request to the NACC database.
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