In a second step, a full structural model was fitted to the data to test the main hypotheses, i.e., that 1) the effect of female sex on dementia is mediated directly by differences in level of educational attainment, and 2) that the effect of female sex on dementia is mediated directly, as well as indirectly via education, by level of general psychological distress, also after controlling for age and APOE ε4 allelic status. The gene discussed is APOE; the disease is Abnormal emotional state.