The explanation for the higher incidence of Alzheimer’s disease in women versus men is complex involving, both biological and sociocultural factors.
Women live longer than men on average and therefore have more Alzheimer’s disease, but potential contributors to women’s high risk include sex hormone exposure, the X chromosome, the prevalence and the effective risk factors such as hearing loss, apoproteinE4, and diminished cognitive reserve related to lower educational levels.
Approximately 2/3 of people living with Alzheimer’s disease in the US is a woman.
A year after being diagnosed with dementia about 27% of men die, compared with 22% of women.
The all cause mortality rate one year after the diagnosis of Alzheimer’s disease is 24% higher for men than for women.
In the presence of Alzheimer disease, pathology, especially neurofibrillary tangles, women’s cognition declines more rapidly, than men’s cognition, and correlates more strongly with neuropathological burden at autopsy in women than in men.
Men and women have similar findings of beta, amyloid, but tau accumulates faster than women than in men.
Benefits of anti-amyloid therapy are more beneficial to men.
Lecanemab treatment affects are smaller among women.
Estradiol protects the brain, inhibits inflammation, allows new neurons to grow, and this process decreases during menopause, leaving the brain potentially more vulnerable.
Compared with women who never used menopause, hormone therapy, those who use estradiol patches have higher episodic memory scores, and those who take estradiol by mouth have higher prospective memory scores.
The same amount of Alzheimer disease pathology causes greater cognitive decline in women, than in men.
The APO E4 genetic variant increases the risk of Alzheimer’s disease in women more than it does in men.
Diabetes, hearing loss, hypertension, vision, impairment, and poor sleep,are linked to worse cognition among women, but not among men.