Why Alzheimer disease hits women harder than men

Alzheimer disease: Scientists are uncovering why women are more affected by Alzheimer disease — and how these insights could transform treatment and prevention.

When Brenda Whittle was diagnosed with Alzheimer Disease in 2015, she was determined not to let it define her life.

The 75-year-old still enjoys activities such as jigsaw puzzles, sewing and dancing. She has also become involved in medical research, volunteering for brain scans and drug trials to help scientists better understand the disease.

Whittle is one of more than 50 million people worldwide living with dementia — a group of conditions that affect memory, thinking and behaviour. Experts predict that number could rise to 75 million by 2030 and more than 130 million by 2050.

Most of those affected are women.

Alzheimer disease: A striking gender gap

In many countries, women account for nearly two-thirds of people living with dementia. In the United States, for example, about two-thirds of Alzheimer’s patients are female.

For older women, the risk can be surprisingly high. Women over 60 are estimated to be twice as likely to develop Alzheimer Disease as they are to develop Breast Cancer.

In countries such as England, Wales and Australia, dementia has even become the leading cause of death among women, surpassing heart disease.

These statistics have pushed scientists to examine why the disease appears to affect women so much more frequently than men.

Living longer is part of the answer

One explanation lies in life expectancy. Age is the greatest risk factor for Alzheimer’s disease, and women generally live longer than men.

Because of this, more women reach the ages at which dementia becomes common.

However, researchers say longevity alone cannot fully explain the gap.

Over the past two decades, new dementia cases in some countries have declined — particularly among older men. Public health campaigns encouraging people to quit smoking and reduce heart disease risk may have contributed to this trend.

Since men historically smoked more and developed heart disease earlier, these campaigns may have benefited them more.

Risk factors that affect women more

Several other risk factors for Alzheimer’s appear to affect women disproportionately.

One is Depression, which is more common among women and has been linked to a higher risk of dementia later in life.

Certain female-specific health events may also play a role. Researchers have found possible links between cognitive decline and:

• Surgical menopause
• Pregnancy complications such as pre-eclampsia
• Hormonal changes associated with ageing

Social roles may contribute as well. Women are more likely to be caregivers for family members with dementia, and some studies suggest the stress of caregiving itself could increase the risk of developing the disease.

The role of hormones

Scientists are also investigating the influence of the hormone oestrogen on the brain.

Oestrogen is believed to protect brain cells earlier in life, supporting memory and cognitive function. However, levels drop sharply after menopause, potentially leaving the brain more vulnerable to neurodegenerative diseases.

This sudden hormonal change may partly explain why women experience greater cognitive decline once Alzheimer’s begins.

Diagnosing the disease

Doctors currently detect Alzheimer’s by looking for toxic protein build-ups in the brain — particularly amyloid plaques and tau tangles.

Interestingly, studies show that men and women with Alzheimer’s often have similar levels of these proteins. Yet women typically experience more severe cognitive symptoms.

Researchers believe this may mean the biological markers used to detect the disease do not predict its progression equally well in both sexes.

Some scientists also suspect that women’s stronger verbal skills can mask early symptoms, allowing them to perform better on initial memory tests. This could delay diagnosis until the disease has progressed further.

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Rethinking research and treatment

Growing awareness of these differences has prompted calls for more sex-specific research.

Advocacy groups such as the Women’s Brain Project are encouraging scientists to analyse Alzheimer’s data separately for men and women. Understanding how the disease develops differently may help doctors design more effective treatments.

Clinical trials may also need adjustment. Many studies recruit roughly equal numbers of men and women, even though the disease is more common among women. Some experts argue trials should better reflect the actual distribution of the disease.

A disease still underfunded

Despite its enormous impact, dementia research remains relatively underfunded compared with other major illnesses.

In the United Kingdom, only a small portion of medical research funding goes toward developing treatments for dementia compared with diseases such as cancer.

Advocates say increased funding is essential to finding better therapies and eventually a cure.

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Hope through research

For patients like Brenda Whittle and her husband Stephen, participating in research offers a sense of purpose.

With the help of reminder notes around the house and a GPS tracker after once boarding the wrong train, she continues to manage daily life while contributing to scientific studies.

Researchers say volunteers like her are vital in helping scientists unravel one of medicine’s biggest mysteries.

By understanding why Alzheimer’s affects women more severely, scientists hope to develop more effective methods for prevention, diagnosis and treatment — potentially improving the lives of millions of people around the world.

Also read: How menstrual blood is helping scientists better understand women’s health