Why do more women than men have Alzheimer disease? The role of sex and gender in dementia
Two thirds of all people with familial, sporadic Alzheimer’s Disease (AD) are women. The estimated lifetime risk for AD at age 45 is approximately one in five (20%) for women and one in10 (10%) for men. After age, being a woman is the greatest risk factor. The predominance is most likely due both to sex (biological factors) and to gender (social factors). In order to prevent AD in women and men, we need to understand both the social and the biological factors affecting them that lead to eventual dementia. In this talk I define sex and gender, giving examples of both and how they may be implicated in sex differences in the risk of AD. There is an overview of what is known about sex differences in AD and its risk factors—modifiable and unmodifiable—focusing on potential reproductive health risks for women and the importance of one of the three naturally occurring estrogens, 17-beta-estradiol for late life brain health. Through the project, Cognition After Bilateral Salpingo-Oophorectomy (CABSOE) we begin to understand that early mid-life treatments of reproductive health problems, sex and gender, may increase women’s risks and may allow the development of more informed treatment strategies for women earlier in life.