Tag Archives: women

Why Are Women Twice as Likely to Get Alzheimer’s Disease?

Of the more than 5 million Americans living with Alzheimer’s disease, nearly 2/3 of them are women. A woman in her 60s has a 1 in 6 chance of later developing Alzheimer’s, compared to only 1 in 11 for a man. What is the cause for this sex imbalance?

A major player in this question is the APOE gene (see The Genetics of Alzheimer’s Disease for more detail). This gene comes in three different forms: APOE2, APOE3, and APOE4. Each of us inherits two copies of this gene (one from each parent). If you have one copy of APOE4, your risk of Alzheimer’s increases threefold, while having two copies of APOE4 increases your risk by fifteen times. For reasons that remain unclear, the APOE4 allele seems to be a stronger risk factor for women than men, which could help to explain the difference in Alzheimer’s prevalence.

Some lines of research suggest that sex hormones may also play a role. Specifically, reduced estrogen levels, which commonly occur during menopause, are associated with increased risk of Alzheimer’s. Several studies have shown that women with Alzheimer’s tend to have lower estrogen levels in their brains. Pregnancy also reduces lifetime exposure to estrogen, which may explain why women who have had biological children have a higher risk of dementia than women without biological children. Similarly, women who have had a hysterectomy or oophorectomy (removal of the uterus or ovaries), which can induce menopause at an earlier age, also have an increased risk of dementia.

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A woman’s estrogen levels decrease as they approach menopause, which may be linked to their increased risk for Alzheimer’s. Image Source

So if low estrogen is a risk factor for Alzheimer’s, could estrogen replacement therapy (ERT) combat this? ERT is commonly used as a treatment for menopausal symptoms such as hot flashes, as well as to reduce the risk of osteoperosis. Clinical trials investigating the effects of ERT on dementia have had mixed results. There is some evidence to suggest that it may only be protective if women begin treatment within the first few years of menopause. So far, the jury is still out on whether these therapies could be beneficial for preventing dementia. There are also some notable risks associated with ERT, including a higher chance of breast cancer.

What about male sex hormones? Similarly to women, men with Alzheimer’s disease tend to have lower levels of testosterone than normal. So if the loss of both sex hormones can increase the risk of Alzheimer’s, why do we see a much higher prevalence in women? One theory is that it relates to how quickly these hormones are lost. The menopause transition usually takes around four years, while male reproductive aging takes place gradually over several decades. Perhaps the abruptness of estrogen loss in menopause is responsible for the higher risk of dementia.

Another important difference between men and women lies in their risk for other dementia-related diseases. Women are more than twice as likely as men to have depression, and they also have a higher risk of insomnia and fragmented sleep. All of these conditions are linked to an increased risk of Alzheimer’s. In addition, women have historically been granted less access to education, employment, and physical exercise, which can be protective against dementia. This is particularly true for women who grew up in the mid-20th century and are now reaching their elderly years.

In conclusion, there’s still a lot we have to learn about why women are more prone to Alzheimer’s disease than men. In the meantime, both women and men can still greatly reduce their overall risk of Alzheimer’s through lifestyle changes. See 10 Tips to Reduce Your Dementia Risk to learn more.

 

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Study Shows How Alzheimer’s Affects Men’s and Women’s Brains Differently

Women are around twice as likely to develop Alzheimer’s disease during their lifetimes compared to men. This effect is also seen in mouse models of the disease. When mice are genetically engineered to developed Alzheimer’s, the female mice tend to have an earlier diseae onset and more severe pathology compared to hte male mice. The reasons for this discrepancy are unknown. However, a recent study published in Neurobiology of Aging attempted to shed some light on the mystery.

The researchers were interested in studying adult neurogenesis, which is our brains’ ability to create new neurons throughout our lives. Neurogenesis primarily occurs in two areas of the brain: the olfactory bulb, which is involved with the sense of smell, and the hippocampus, which is important for memory. In this study, the scientists wanted to figure out whether neurogenesis in the hippocampus was different for male and female mice with Alzheimer’s disease.

First, they subjected the mice to a test designed to test spatial memory, which is particularly important for the hippocampus. They placed the mice in a container with two objects and allowed them to explore for a few minutes. The next day, they placed the mice back in the container, but now one of the objects had been moved to a new location. We would expect the mice to spend more time sniffing and investigating the object that had been moved, and less time sniffing the object that was in the same place as before.

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When one of the cups is moved to a new location, the mouse should spend more time sniffing it compared to the cup that wasn’t moved. This test is used to analyze the mouse’s spatial memory. Image Source

The result was interesting. While the male mice had no trouble rembering which cup had been moved, the female mice did significantly worse, spending the same amount of time sniffing both of the cups. This suggested that the female mice might have some impairment in their spatial memory.

Next, the researches looked at the mice’s brains. They used a technique that caused all newly-born neurons to be labeled bright green, and counted how many neurons were born in the hippocampus during a two-week period. The male mice produced more than four times as many neurons as the female mice. Conversely, the female mice had nearly twice as many astrocytes in their hippocampi compared to the males. Astrocytes are another type of brain cell that is often associated with inflammation. These results suggested that the female mice’s brains were producing many astrocytes but few neurons, perhaps contributing to their impaired spatial memory.

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This image from the paper shows astrocytes labeled in red. In the top right panel, you can see that the female Alzheimer’s (APP/PS1) mice have far more red area than the males, indicating a greater number of astrocytes.

The results of this study suggest that the brains of female mice with Alzheimer’s may be devoting so many resources to creating new astrocytes that there’s not enough left to create neurons. However, it opens up many new questions. What is causing this overproliferation of astrocytes in the female mice? The authors of the paper suggest estrogen as a possible cause, since this hormone has been shown to influence memory. Additional studies are needed to determine the true cause.

 

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