Women and Alzheimer’s: The inequity of higher risks, impacts
Research shows that women are at increased risk for the disease.
While there have been strides made in the equality of men and women, many inequalities still exist. Unfortunately, one of these inequalities lies in the risks and impacts of Alzheimer’s or other dementia faced by women.
Over 6 million Americans are currently living with the disease, and that number is expected to grow to 13 million by 2050, according to the Alzheimer’s Association. In the United States, almost two-thirds of all Americans living with Alzheimer’s are women.
Some of this inequality may come from within female genes. Scientists have identified a gene that appears to increase the risk of Alzheimer’s in women, providing a potential new clue as to why more women than men are diagnosed with the disease.
The gene, O6-methylgua-nine-dna-methyltransferase, or MGMT, plays an important role in how the body repairs damage to DNA in both men and women. But researchers did not find an association between MGMT and Alzheimer’s in men. This female-specific finding is perhaps one of the strongest associations of a genetic risk factor for Alzheimer’s in women.
While two-thirds of all Alzheimer’s cases are in women, an overwhelming majority don’t know they are at an increased risk for the disease. According to Rhonna Shelly Shatz, D.O., Bob and Sandy Heimann Chair in Alzheimer’s Disease Research and Education and Director of Cognitive Disorders Clinic at the University of Cincinnati Department of Neurology and Rehabilitation, healthcare professionals should share in the responsibility of changing that lack of understanding.
“As healthcare providers, we have a responsibility to impart to women an understanding of cognitive impairment, and what they can do to reduce their risk,” said Shatz. “Ideally this should take place before they show signs of dementia. High blood pressure, high cholesterol, lack of exercise, diabetes can all influence the risk for Alzheimer’s. Younger women should adopt healthy lifestyles that not only improve their overall physical health, but also promote a healthy brain and reduce their risk for cognitive decline later on.”
“If women don’t know that they’re at a much higher risk for Alzheimer’s disease, they also don’t know to take action to help reduce some of that risk,” she added. “As doctors, we need to understand what is going on in a patient’s life, both medically and emotionally, that greatly influences who they are at the current time, and the path they are on regarding their health. Events that may seem minor can in fact have a great influence on their physical and mental well-being.”
One pertinent example of this comes from Shatz’s personal life. “My mother, who is living with Alzheimer’s, made mention of being sensitive to spicy foods. A few months later, she announced she was having surgery to have “something” removed from her mouth. After some digging, we discovered my mother’s dentist had identified a pre-cancer in her mouth and needed to remove the mass. My mother considered it no big deal and let the issue go on for months.”
“I keep asking myself how could I, a medical doctor, who deals with these issues every day, have missed the warning signs that
my mother’s judgment was impaired? It is so important to be educated about cognitive decline warning signs, and for caregivers and families to be vigilant in recognizing and processing the health signals from those they care for.”
Shatz encourages women to talk to their primary care providers about what they can do to protect their cognitive health, now and in the future. “Women should open up these conversations in their 20s, 30s and 40s,” Shatz said. “It’s never too early. But it’s never too late either. Older women can still guard against cognitive decline or dementia. Don’t sit back and resign yourself to the thought that losing brain function is a normal part of aging. Research is demonstrating that it doesn’t have to be.”
A new study has good news when it comes to giving women a chance to reduce their increased risk. Personalized lifestyle interventions — such as diet, exercise, stress reduction and sleep hygiene — were found to reduce Alzheimer’s risk factors in both sexes, but they worked even better in women. Lifestyle changes such as increased exercise, improved sleep and diet, and reduced stress can impact brain health.
In addition to learning more about why the genetics of being a woman increases the risk of cognitive impairment, women can join clinical trials investigating the issues of women and Alzheimer’s risk. Women interested in finding out more about clinical trials can go to the Alzheimer’s Association’s Trialmatch® at alz. org, a free matching tool for research studies and treatment trials for Alzheimer’s and other dementia.
While lifestyles are proving to have a marked influence on risks, not everything that makes up a person’s lifestyle is by choice. Historically, women have fulfilled the role of caregiver for the family. When caregiving is provided to a loved one with Alzheimer’s or other dementia, the toll on the caregiver can be high.
Shatz is only one of more than 11 million family and friends who provide unpaid care for loved ones living with Alzheimer’s. According to the Alzheimer’s Association statistics, these challenging and stressful caregiving responsibilities often fall on female shoulders:
■ More than 60 percent of Alzheimer’s and dementia caregivers are women. More specifically, more than one-third of dementia caregivers are daughters.
■ The overwhelming majority of dementia caregivers who indicate a need for individual counseling (85 percent) and respite care (84 percent) are women.
■ Nearly 19 percent of female Alzheimer’s caregivers had to quit working either to become full-time caregivers or because their caregiving duties became too burdensome.
■ Two and a half times as many women as men reported living with the person with dementia full time. Of those providing care to someone with dementia for more than five years, 63 percent were women.
Jacki Williams volunteers with the Alzheimer’s Association as a community program educator, a team captain for the Walk to End Alzheimer’s and a member of the National Volunteer Advisory Panel.
Williams had to leave her job to become her mother’s full-time caregiver. “When my family relocated to Ohio from North Carolina so I could care for my mother, it completely changed our family’s financial health. It really set us back in saving and putting away for college. A lot of sacrifices were made by my kids and our entire family.”
Financial hardships are commonly faced by caregiver households, in fact, about 25 percent of these caregivers say it is difficult to find affordable services for their care recipient
While the landscape for women and the impact of Alzheimer’s may seem overwhelming, women should be empowered to improve their risks of the disease and the stress of caring for a loved one living with the disease. Women who want to know more should visit www.alz. org/alzheimers-dementia/ what-is-alzheimers/women-and-alzheimer-s or the Alzheimer’s Association 24/7 Helpline at 800-272-3900.