Project Summary Women are disproportionally affected by Alzheimer's disease and Alzheimer's disease-related dementias (AD/ADRD) with approximately two-thirds of individuals diagnosed with this condition being women. Studies have revealed substantial sex and gender disparities in AD/ADRD care and outcomes, with women being less likely to receive annual blood pressure and weight monitoring, and more likely to experience delayed initiation of anti-dementia medication than men. Despite a growing body of literature documenting sex and gender disparities in AD/ADRD care, research on underlying causes of these disparities remains limited. Research on healthcare in general (not focusing on AD/ADRD care) indicates that patient-physician gender concordance, gender diversity of physicians' training environments, and health system board diversity are associated with the care quality and outcomes. However, their impact on sex and gender disparities in AD/ADRD care has not been investigated. The proposed study will address this important knowledge gap by analyzing the nationally- representative data on patients, physicians, medical schools, residency programs, and health systems, that will be developed by linking 5 nationally-representative databases (Medicare Claims Data, Doximity Physician Data, Association of American Medical Colleges Medical School Data, American Medical Association Residency Program Data, and American Hospital Association National Health Care Governance Survey Data). In Aim 1, using this comprehensive database, we will investigate the effect of patient-physician gender concordance on sex and gender disparities in AD/ADRD care and outcomes (e.g., anti-dementia medication use, annual depression screening). In Aim 2, we will examine the effect of gender diversity in medical schools and residency programs attended by the physician (the proportion of female students and faculty at the medical school attended by the physician; the proportion of female residents and female patients with AD/ADRD at residency program completed by the physician) on sex and gender disparities in AD/ADRD care and outcomes. In Aim 3, we will investigate the effect of health system board diversity (the gender composition of health system boards) on sex and gender disparities in AD/ADRD care and outcomes. This project will provide a robust evidence base for policymakers to develop policy interventions (e.g., increasing female representation in physician workforce, introducing sexual and gender sensitivity in medical education, and promoting sex and gender diversity in health system boards) that could effectively mitigate sex and gender disparities in AD/ADRD care. The research team consists of investigators with expertise in all relevant fields (AD/ADRD care, geriatric care, women's health, and physician-level determinants of the quality of care) to conduct this innovative research.