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Addressing Sex Differences in Alzheimer’s Disease and Other Dementias

March 23, 2016

Forty-seven million people are living with dementia around the world, and experts expect that number to double almost every 20 years. More women live with dementia, and women are more at risk of developing the disease.

A commission formed by The Lancet Neurology published a 532-page report this week offering expert research policy recommendations to confront the growing global problem of dementia in Europe.

The journal invited Dr. Carolyn M. Mazure, Director of Women’s Health Research at Yale, to provide a commentary to accompany the report. Dr. Mazure asked Dr. Joel Swendsen, Director of Research at the University of Bordeaux in France, to co-author the commentary.

The authors called for researchers to focus on the effect of sex on Alzheimer’s disease (AD) and other dementias to better guide health care providers in caring for both women and men.

“Advances have been made in various fields, from cardiology to addiction medicine, by analyzing the effects of sex on outcomes,” Mazure and Swendsen wrote. “The Lancet Neurology Commission provides a timely opportunity to embrace this approach in the research agenda for AD and other dementias.”

The authors presented an overview of the latest research concerning sex and gender differences involving the development, incidence, and treatment of dementias, from brain growth that begins before birth to differing progression of the disease in adults.

In addition, Mazure and Swendsen explore the different ways in which dementias appear in men and women, with men showing more aggressive behaviors, more additional disorders, and higher rates of death. Women show more symptoms of affective disorders such as depression and anxiety but also survive longer.

Established sex differences in biochemistry and lifestyle choices such as diet, exercise, and tobacco and alcohol use can affect treatment and the risk of disability. And societal imbalances play a role. For example, education and occupation levels affect the risk of dementia.

“In brief, an individual’s behaviors and experiences over the lifespan affect the brain, and many of these factors vary by sex,” the authors said.

Mazure and Swendsen stress the urgent need to plan for the shifting demographics around the world in which women are both becoming more active outside the home while also continuing to take on the increasing burdens of caring for aging partners who suffer from dementia.

“The availability of resources differs substantially across countries, yet the needs of a growing population of people with dementias cannot be met by public and social-care sectors alone,” Mazure and Swendsen said, “prompting important questions about the role of women in future caregiving.”

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Submitted by Carissa R Violante on March 23, 2016