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Almost two-thirds of Americans living with Alzheimer's disease are women, and women in their 60s are twice as likely to develop Alzheimer's as they are breast cancer. They're also more likely than men to develop the brain disease, even after factoring in women's typically longer lifespans. New research presented today at the Alzheimer's Association International Conference 2019 suggests that sex-specific genes and crucial differences in the brain may help explain why women appear to be more at risk for this devastating disorder.
"These new studies make clear that there are biological and perhaps environmental factors that account for sex differences,” says Gary Small, M.D., Parlow-Solomon Professor on Aging at the David Geffen School of Medicine at UCLA. “Just like we take gender into account when determining risk for other health conditions, like depression or heart disease, we need to be aware of its impact on Alzheimer's, as well."
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Four studies presented today make clear that the brains of women are structured differently than men, and that that in turn may impact risk of Alzheimer's.
The first study relates to something that has always puzzled Alzheimer's researchers — that women tend to outperform men on verbal memory tests, even when both have similar levels of Alzheimer's brain-related changes. As a result, women are often diagnosed in the later stages of Alzheimer's since early screening tests, which include verbal memory tests, may not detect any cognitive impairment.
In the study, researchers gave over 1,000 older adults brain scans to measure levels of amyloid plaque, one of the hallmarks of the disease. They also measured how well the participants’ brains metabolized glucose in regions affected by Alzheimer's. “Glucose is the primary energy source of the brain, so having trouble metabolizing it could indicate brain dysfunction,” explains study author Erin Sundermann, a neuropsychologist at the University of California San Diego School of Medicine.
Then when they gave both men and women verbal memory tests, they found, not surprisingly, that women were able to outperform their male peers when mild to moderate amyloid plaque was present. But they also discovered that women were metabolizing more brain glucose. “This suggests that women actually have better brain efficiency, and that they're able to use the glucose to help compensate for a growing brain deficit,” says Sundermann.
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