Biological differences matter

The neurophysiological differences in brain structure and function between binary biological sexes (male and female) are well established. These differences can lead to variations in the susceptibility, presentation, clinical features, prognosis, and management of certain neurological diseases. For instance, it has been shown that there are clear sex-specific differences in the behavioural manifestations of Alzheimer’s disease (AD), a debilitating neurodegenerative disease that is the most common cause of dementia worldwide. Ott et al. determined that biological males with AD show more apathy and vegetative signs, whereas biological females show more reclusiveness and emotional lability. Further, in patients with AD who have moderate cognitive deterioration (Global Deterioration Scale score of 5 or 6), men more commonly demonstrate physical aggression, whereas women are more verbally agitated and have higher rates of anxiety and depression.These differences allow clinicians to tailor AD management toward sex-specific presentations, leading to better patient care; however, these important findings are not accounted for as often as they should be in the diagnosis of neurological disease.