On Alzheimer's

2/3 cases are female — yet women are diagnosed far later than men

One thing we hear over and over again here at Asterisk is, “I didn’t realize how bad women’s non-reproductive health is.” Even our new members are shocked when they search for current clinical trials and see that women are still excluded ‘to avoid the influence of the hormonal cycle.’

That is why we introduced this series. We believe education goes hand-in-hand with solution-building. This week, we’re focusing on the disease that took founding member Veronica’s grandmother.

Problem:

• Women are more likely to experience Alzheimer’s but are diagnosed later due to criteria for symptoms tailored for men.

• Women over 60 are twice as likely as men to develop Dementia

• Some people believe this is because women live longer than men. That is far from the only cause, as women from the age of 40 have higher beta-amyloid levels and more brain shrinkage compared to men the same age.

• Women show stronger verbal skills when they present with dementia compared to men. As dementia often is diagnosed based on language and vocabulary, women are more often misdiagnosed.

“Oestrogen affects how a woman’s brain grows and functions. Researchers think this might be why women have a better memory for words and verbal items than men. This poses a problem for men and women.

Research suggests that diagnostic tests specifically designed for men and women might led to less misdiagnosis than using the same test for both sexes. This is because women tend to have a stronger verbal memory than men, so may do well on memory tests, even if they have cognitive problems. This means they are under-diagnosed with dementia. Men on the other hand are more likely to be incorrectly diagnosed with dementia because their verbal memory skills might not be as strong.

Studies have found that women's superior verbal skills might actually mask the early signs of dementia. Researchers from the University of California in San Diego conducted a study where verbal memory skills were tested in individuals with varying degrees of Alzheimer's and cognitive impairment. They discovered that women, who typically have better verbal memory skills, could show the same level of cognitive impairment as men but with lower levels of brain metabolism, indicating their cognitive issues were more advanced.

This finding highlights a significant challenge in diagnosing Alzheimer's early in women, as they may not be diagnosed until they are further along in the disease due to their stronger verbal abilities. Better verbal skills in women could mask early dementia signs Adjusting memory tests to account for gender differences in verbal memory skills could be crucial for early detection and treatment of Alzheimer's in women. Better verbal skills in women could mask early dementia signs.” — Sunderman, 2016

Consequence:

• Women are diagnosed at a far more progressed state of the disease and might not receive the early intervention, treatment, and support they require.

References:

• (Alzheimer’s Research UK) https://www.alzheimersresearchuk.org/news/why-women-are-bearing-more-of-the-impact-of-dementia/

• (Oveisgharan et al. 2018) https://link.springer.com/article/10.1007/s00401-018-1920-1

• Erin Sunderman (2016, Neurology) https://pubmed.ncbi.nlm.nih.gov/27708128/

Question for thought:

• Dementia seems to be linked to oestrogen. Could this be caused by hormonal birth control? As we can see a difference in men and women’s brain from the age of 40?

• Use the comment section to share your experience, thoughts, and resources.