APOE and Alzheimer disease: Additionally, AD disproportionately affects women, who account for nearly two-thirds of all cases, partly due to genetic factors such as the APOE-ε4 allele, which has a stronger association with AD in women [29], and the neuroprotective role of estrogen, which declines after menopause, leading to increased neuroinflammation and β-amyloid accumulation [30].