Diagnosis-stratified analyses revealed that this effect was not significant in either of the stratified groups, likely due to the smaller subsample sizes, but there was a trend for a faster decline in MMSE scores in relation to higher baseline plasma free MMP-9 in women with AD (β=−3.77; 95% CI, −7.58 to 0.02; p=0.053). This evidence concerns the gene MMP9 and Alzheimer disease.