Almost two thirds of patients are women. Is it just that they live longer, or are there other reasons?
What else could be wrong? Genetics? Biological differences in the aging process? Lifestyle? Answers to these questions can be important for the treatment and prevention of this serious disease.
One in six women aged 65 will develop the disease before the end of their lives, while among men of the same age only one in eleven will get sick, according to a report from the Association for the Study of Alzheimer’s Disease. The organization recently invited 15 leading scientists to discuss the latest findings regarding the increased risk of disease in women. The scientific director of the association Maria Carrillo (Maria Carrillo) said that they are ready to fund further research in this area.
The most difficult thing to determine is how much of the increased risk of developing the disease in women is due to their longer life expectancy, and how much is due to other factors. “Indeed, age is a major risk factor for developing Alzheimer’s disease, but on average, women live 4-5 years longer than men, and we know that the first damage at the cellular level can begin 20 years before diagnosis,” says the professor at the University of Southern California Diaz Brinton, author of a presentation on sex differences in the course of Alzheimer’s disease at a conference hosted by the US National Institutes of Health.
Regardless of how the disease starts, it progresses faster in women – brain scans show that in them, the affected areas of the brain degrade (reduce in volume) faster.
However, the clearest evidence for sex differences came at the genetic level. Researchers at Stanford University studied data from more than 8000 people to identify those who carry a variant of the ApoE-4 gene, which has previously been shown to increase the risk of developing Alzheimer’s disease. It turned out that in women, this gene more than doubles the risk, and in men – only slightly. Perhaps this is due to the interaction of the gene with the female sex hormone estrogen. Estrogen supplementation after age 65 has previously been shown to increase the risk of dementia, but new evidence suggests that if hormone replacement therapy is started already at the time of menopause, then these problems do not arise.
Diaz Brinton tests the hypothesis that women become vulnerable to the disease after menopause. Estrogen helps regulate brain metabolism; when estrogen levels drop during menopause, the brain has to switch to a less efficient method of regulation.
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