We investigate sex-specific topological structures associated with typical Alzheimer's disease (AD) dementia using a novel state-of-the-art latent space estimation technique. This study applies a probabilistic approach for latent space estimation that extends current multiplex network modeling approaches and captures the higher-order dependence in functional connectomes by preserving transitivity and modularity structures. We find sex differences in network topology with females showing more default mode network (DMN)-centered hyperactivity and males showing more limbic system (LS)-centered hyperactivity, while both show DMN-centered hypoactivity. We find that centrality plays an important role in dementia-related dysfunction with stronger association between connectivity changes and regional centrality in females than in males. The study contributes to the current literature by providing a more comprehensive picture of dementia-related neurodegeneration linking centrality, network segregation, and DMN-centered changes in functional connectomes, and how these components of neurodegeneration differ between the sexes. We find evidence supporting the active role network topology plays in neurodegeneration with an imbalance between the excitatory and inhibitory mechanisms that can lead to whole-brain destabilization in dementia patients. We find sex-based differences in network topology with females showing more default mode network (DMN)-centered hyperactivity, males showing more limbic system (LS)-centered hyperactivity, while both show DMN-centered hypoactivity. We find that brain region centrality plays an important role in dementia-related dysfunction with a stronger association between connectivity changes and regional centrality in females than in males. Females, compared to males, tend to exhibit stronger dementia-related changes in regions that are the central actors of the brain networks. Taken together, this research uniquely contributes to the current literature by providing a more comprehensive picture of dementia-related neurodegeneration linking centrality, network segregation, and DMN-centered changes in functional connectomes, and how these components of neurodegeneration differ between the sexes.
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