How Alzheimer’s is Different for Women and Men

Diagnosed with Alzheimer’s four years ago, 75-year-old Elaine still enjoys jigsaw puzzles, knitting, and dancing. She manages day-to-day life with the help of a GPS tracker – prompted after a trip on the wrong bus – and with reminder notes stuck around the house by her husband Fred, who is also in the beginning stages of the disease himself. They both participate regularly in Alzheimer’s discussions and research, and plan to continue to involve themselves for as long as they can.

Research conducted with gender at the forefront is raising new possibilities for how we detect, treat, and support the growing number of people living with Alzheimer’s. This makes the involvement of couples such as Elaine and Fred essential when it comes to Alzheimer’s research. Scientists believe that pinning down any similarities and differences in how the disease affects men and women could help tremendously with solving some of the medical mysteries behind the disease.

The Prevalence of Alzheimer’s in Men and Women

Elaine and Fred in our example are two of the more than 50 million people worldwide living with dementia. That number is rising quickly. Globally, experts estimate that 75 million people will live with dementia by 2030 and 131.5 million by 2050.

Until a few years ago, many researchers thought more women were living with Alzheimer’s because they live longer than men. Now that idea is less popular. Rather, some studies have found the difference between men and women in the risk of developing Alzheimer’s can be attributed to other related health factors.

Research Suggests Differences Between Men and Women with Alzheimer’s

Research reported at the Alzheimer’s Association International Conference (AAIC) this year identified a number of differences in the progression and risk of Alzheimer’s disease between women and men, including newly identified sex-specific risk genes and contrasting presentation of Alzheimer’s biology in the brain. These are some of the findings from AAIC and the Society for Women’s Health Research Interdisciplinary Network:

Higher prevalence in women: More women than men have Alzheimer’s or other dementias.

– Almost two-thirds of Americans with Alzheimer’s are women.
– Of the 5.6 million people age 65 and older with Alzheimer’s in the United States, 3.5 million are women and 2.1 million are men.
– Among people age 71 and older, 16% of women have Alzheimer’s or other dementias compared with 11% of men.

Cardiovascular disease at an earlier age: Men have more of a risk of dying of cardiovascular disease in middle age. Men who survive beyond age 65 may have a healthier cardiovascular risk profile and will therefore have a lower risk for dementia than women of the same age.

Genetic variations: A number of studies have shown that the APOE-e4 genotype, the best known genetic risk factor for Alzheimer’s dementia, may have a stronger association with Alzheimer’s dementia in women than in men. Evidence suggests that the reason may be due to an interaction between the APOE-e4 genotype and the sex hormone estrogen.

Women often get diagnosed later: Researchers found that women with Alzheimer’s in its early stages may go undiagnosed because they tend to do better on verbal tests than men, which masks Alzheimer’s damage. The downside of women performing well on these tests even in the presence of pathology, is that the diagnosis for mild cognitive impairment and Alzheimer’s disease may be delayed. By the time women are diagnosed with these conditions, they already have a more severe disease burden and decline more rapidly compared to men.

Women have twice the risk of developing depression than men: Depression is linked to higher Alzheimer’s risk and women are 2x more likely to have depression than men.

Risk factors that only affect women: Certain risk factors affect only women, such as surgical menopause (surgery to remove the ovaries) and pregnancy complications such as preeclampsia (high blood pressure during pregnancy), both of which have been linked to cognitive decline in later life.

Women have a higher caregiver burden than men: Women, who make up about 60% of all family caregivers for Alzheimer’s patients, are more likely to leave their job to care for a family member. Some studies suggest that spousal caregivers may be at a higher risk of cognitive impairment or Alzheimer’s than non-caregivers. The reason is that working outside the home is good for the brain, according to a University of California Los Angeles study of more than 6,000 women born between 1935 and 1956.

More research is needed to better understand how Alzheimer’s disease differs between women and men.

It’s remarkable that scientists are only now beginning to understand sex differences in Alzheimer’s, says Dallas Anderson, a neuroepidemiologist at the National Institute on Aging. “Sex is such a basic variable, you’d think that we really would have nailed things down by now,” he says. “But no.” The National Institutes of Health is working to change that by funding more research into sex differences in the brain, Anderson says. We will keep you updated as we hear more developments regarding gender-related Alzheimer’s research.

Planning for a Loved One with Alzheimer’s

Do you have a loved one who suffers from Alzheimer’s or another form of dementia? Persons with Alzheimer’s disease and their families face special legal and financial needs. At the Farr Law Firm, we are dedicated to easing the financial and emotional burden on those suffering from Alzheimer’s and their loved ones. Through the process of Life Care Planning and Medicaid Planning (also called Medicaid asset protection planning), we help protect a family’s hard-earned assets while maintaining your loved one’s comfort, dignity, and quality of life by ensuring eligibility for critical government benefits such as Medicaid and Veterans Aid and Attendance. If your family is facing a diagnosis of Alzheimer’s disease or any other type of dementia, please call us as soon as possible to make an appointment for a consultation. The sooner you plan for long-term care after a diagnosis of dementia, the mare planning options you have.

Medicaid Planning Fairfax, VA: 703-691-1888
Medicaid Planning Fredericksburg, VA: 540-479-1435
Medicaid Planning Rockville, MD: 301-519-8041
Medicaid Planning Washington, DC: 202-587-2797

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About Evan H Farr, CELA, CAP

Evan H. Farr is a 4-time Best-Selling author in the field of Elder Law and Estate Planning. In addition to being one of approximately 500 Certified Elder Law Attorneys in the Country, Evan is one of approximately 100 members of the Council of Advanced Practitioners of the National Academy of Elder Law Attorneys and is a Charter Member of the Academy of Special Needs Planners.

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