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• Posted April 9, 2026

Alzheimer’s Tests May Mask Risks for Women

The tools doctors use to diagnose Alzheimer’s disease may miss telltale changes in women, new research shows.

Women account for nearly two-thirds of Alzheimer’s cases in the United States.

But standard screening tools rely on a one-size-fits-all approach that doesn't account for how differently male and female brains age, according to a Georgia State University study.

The study, published April 3 in Brain Communications, focused on a test commonly used to screen for mild cognitive impairment, also known as MCI. MCI is the critical middle ground between normal aging and full-blown Alzheimer's.

The problem? A woman might ace the 30-point Mini-Mental State Examination even while her brain is physically struggling.

For the study, researchers analyzed MRI brain scans of 332 people at various stages of the disease. They looked at volume of grey matter, the brain tissue that helps support thinking, movement and memory. 

They found that women's brains seem to compensate for early damage by relying on a wider range of brain regions to maintain their performance. This may conceal the disease from standard screening tools.

“A woman who scores well on the MMSE in the MCI stage may still be showing underlying brain changes that are not fully captured by that score alone,” senior author Mukesh Dhamala, a professor of neuroscience, said in a news release.

He and his colleagues found that healthy brains had comparable volumes of grey matter in men and women. But once mild cognitive impairment was detected, differences emerged. 

In men, brain shrinkage (atrophy) tended to happen earlier in the transition from healthy aging to mild impairment. However, once women reached the stage of mild impairment, their brains showed steeper and more widespread decline.

This means that by the time a woman’s test scores finally begin to drop, the physical damage to the brain may be quite advanced. This masking effect could delay care.

Researchers believe their findings lay the groundwork for more personalized medicine. 

Instead of giving everyone the same test with the same passing score, doctors could eventually adjust their interpretations based on whether the patient is male or female, and consider factors like hormones and genetics.

“The long-term hope is that findings like ours will lead to sex-specific screening windows and earlier, more precise interventions,” Dhamala noted. For women, those windows might eventually include midlife or postmenopause, when hormonal shifts significantly impact brain health.

He said staying mentally and physically active, managing vascular health and talking to a doctor about family history or genetic risk of dementia and related disorders are good steps to protect brain health.

More information

Visit the National Institute on Aging to learn more about mild cognitive impairment.

SOURCES: Georgia State University, news release, April 2026; Brain Communications, April 3, 2026