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We measured cortical thickness (CTh) and hippocampal subfield volumes (HpS) using FreeSurfer. Adjusted linear models were used to analyze sex\u2010differences and the relationship between atrophy and cognition.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Compared to same\u2010sex HCs, female EOAD subjects showed greater cognitive impairment and broader atrophy burden than male EOAD subjects. In a direct female\u2010EOAD versus male\u2010EOAD comparison, there were slight differences in temporal CTh, with no differences in cognition or HpS. CSF tau levels were higher in female EOAD than in male EOAD subjects. Greater atrophy was associated with worse cognition in female EOAD subjects.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>At diagnosis, there are sex differences in the pattern of cognitive impairment, atrophy burden, and CSF tau in EOAD, suggesting there is an influence of sex on pathology spreading and susceptibility to the disease in EOAD.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ene.15531","type":"journal-article","created":{"date-parts":[[2022,8,25]],"date-time":"2022-08-25T11:58:24Z","timestamp":1661428704000},"page":"3623-3632","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Sex differences in early\u2010onset Alzheimer's disease"],"prefix":"10.1111","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9692-1570","authenticated-orcid":false,"given":"Jos\u00e9","family":"Contador","sequence":"first","affiliation":[{"name":"Alzheimer\u2019s Disease and Other Cognitive 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