Two-Thirds Of Alzheimer’s Disease Patients Are Women. Experts Explain Increased Vulnerability

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Women’s Health Month: Women are more susceptible to Alzheimer’s disease than men. Alzheimer’s disease is a progressive neurological disorder that slowly destroys memory and thinking skills, deteriorates the ability to make conversation and respond to the environment, and renders a person unable to perform the simplest tasks. The disease begins with memory loss, and is the most common form of dementia, an umbrella term used to describe the loss of cognitive functioning. 

In patients with Alzheimer’s disease, abnormal clumps called amyloid plaques and entangled bundles of fibres called neurofibrillary are formed in the brain. Alzheimer’s disease patients experience loss of connections between neurons in the brain. The initial damage occurs in the parts of the brain involved in memory, and later affects regions in the cerebral cortex, which are responsible for reasoning, language and social behaviour, according to the US National Institutes of Health (NIH). 

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Why women are more vulnerable to Alzheimer’s disease than men

Women are more vulnerable to the onset and progression of Alzheimer’s disease than men due to several factors, including biological, genetic and hormonal influences.

“Two-thirds of the Alzheimer’s patients in the world are women. The discrepancy can be attributed to several factors, including biological, genetic, and lifestyle influences,” Dr Atul Prasad, Principal Director & HoD, Neurology, BLK Max Super Speciality Hospital, told ABP Live.

He said that a biological factor which contributes to the higher prevalence of Alzheimer’s disease in women than in men is their longer average lifespan compared to men. “As age is the greatest risk factor for developing Alzheimer’s disease, the increased longevity of women means they have a greater likelihood of living into the age range where the disease commonly manifests.”
Dr Prasad said that hormonal changes also play a role in Alzheimer’s disease. He explained that oestrogen, a hormone which fluctuates significantly in women during reproductive years and declines after menopause, is believed to have a protective effect on the brain. Therefore, the decrease in oestrogen levels after menopause may contribute to an increased susceptibility to Alzheimer’s disease. 

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Explaining the role of genetics in the gender disparity of Alzheimer’s disease, Dr Prasad said: “The apolipoprotein E (APOE) gene, specifically the APOE-ε4 allele, is a known genetic risk factor for Alzheimer’s disease. Studies have shown that women have a higher prevalence of the APOE-ε4 allele, which increases their risk of developing the disease.”

Dr Prasad said that lifestyle choices and social factors also contribute to the higher prevalence of Alzheimer’s disease in women. Also, several women take care of family members with Alzheimer’s disease, which can lead to chronic stress in those women, and impair their cognitive health.

“Women tend to have higher rates of obesity and cardiovascular risk factors, such as high blood pressure and diabetes, which are known to increase the risk of Alzheimer’s disease. Additionally, women often take on caregiving responsibilities for family members with Alzheimer’s disease, which can lead to chronic stress and potentially impact their own cognitive health,” Dr Prasad explained.

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According to Dr Ankita Chandna, Associate Professor, Obstetrics and Gynaecology, Max Super Speciality Hospital, Shalimar Bagh, social and environmental factors such as education attainment may be responsible for the disparity in the prevalence of Alzheimer’s disease. 

Anatomical differences in cerebral blood flow and density of amyloid plaques in the brain also contribute to the gender disparity in the prevalence of Alzheimer’s disease.

“Differences in brain structure between women and men are linked to increased prevalence of Alzheimer’s disease in women. For example, unusual protein deposits known as amyloid plaques, a characteristic of Alzheimer’s disease, are found to be present in greater density in women’s brains which put them at an increased risk. Moreover, blood flow to the brain is important in the effective working of the brain. Some studies suggest that older women have reduced cerebral blood flow than men, leading to impaired brain functioning in women as they age,” Dr Mithee Bhanot, Senior Consultant, Obstetrics and Gynaecology, Apollo 24|7, and Apollo Hospitals, Sector-26, Noida, told ABP Live.

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According to Dr Prasad, addressing the gender disparity in Alzheimer’s disease requires a comprehensive approach, which includes promoting healthy lifestyles such as regular exercises, a balanced diet, and cardiovascular health management. He also said that raising awareness about the importance of early detection of Alzheimer’s disease and seeking medical intervention can lead to timely diagnosis and intervention strategies that may slow down the progression of the neurodegenerative disease.

“Further research is needed to better understand the complex interplay between biology, genetics, and lifestyle factors that contribute to the higher prevalence of Alzheimer’s disease in women. By gaining a deeper understanding of these factors, we can develop targeted prevention strategies, early detection methods, and effective treatments to mitigate the impact of Alzheimer’s disease and improve the quality of life for those affected,” Dr Prasad concluded.

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As experts suggested, focusing on health after menopause, understanding genetic risk factors for Alzheimer’s disease, improving lifestyle choices, consuming a balanced diet, exercising regularly, monitoring cardiovascular risk factors such as high blood pressure and diabetes, and seeking medical health on time in case symptoms are visible, can help reduce the risk of the neurodegenerative disease in women.

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