Highlights
Female individuals demonstrated significantly higher neuritic plaque burden compared with male individuals, with an adjusted odds ratio of 1.65 after controlling for sociodemographic factors, vascular comorbidities, and apolipoprotein E ε4 (APOE ε4) status. APOE ε4 carriers of both sexes exhibited approximately four-fold greater odds of amyloid plaques compared with noncarriers. The protective effect of African ancestry against high plaque burden—observed in Black noncarriers and those without African ancestry—was substantially weakened among APOE ε4 carriers. Among individuals with moderate-to-frequent neuritic plaques (CERAD score ≥2), women were 25% more likely than men to reach advanced Braak stage V-VI tau pathology.
