Studies looking into the prevalence and incidence of dementia in our population suggest that more women are diagnosed with dementia than men. One in 5 women over the age of 45 are diagnosed with dementia vs 1 in 10 men. This pattern is seen worldwide and finds that women commonly also have more severe symptoms and holds true especially in middle and lower income areas.
Dementia is defined as a group of symptoms that affect memory, thinking, and interferes with daily life. There are many types of dementia. The most common type of dementia is Alzheimer’s disease which is a chronic neurodegenerative disease that causes problems with memory, thinking, and behaviour. Vascular dementia is the second most common type of dementia. It is a condition where lack of blood flow to the brain causes problems with reasoning, planning, judgement, and memory.
Some risk factors that contribute to the onset of dementia in women include:
The older you are the more you’re likely to develop late-onset Alzheimer’s. Women have a longer life expectancy than men therefore more have dementia. More women reach their 80s and 90s when the dementia risk increases.
Depression has been linked to the onset of Alzheimer’s and women are more likely to develop depression than men. People with depression also show shrinkage in the hippocampus which is a central structure for memory.
- Surgical menopause and pre-eclampsia have been linked to cognitive decline later in life.
- Social roles (eg. Caregiver roles) are also a risk factor for dementia and the vast majority of caregivers are women (60-70% of caregivers are women).
- Brain functional differences.
Women better metabolize sugar (energy for the brain) which may give them more ability to compensate for the damage from dementia and make them less likely to be diagnosed early on. Furthermore, more the damaging Tau protein network in women are denser and more spread out suggesting that more areas of the brain are affected. In addition, women with the APOE4 gene have a greater risk of developing dementia vs men with the same gene present.
Studies have found that the incidence of dementia overall rises exponentially to the age of 90 years. Any sex differences are small, and incidence is lower in East Asia than in Europe. Compared with men, women have an increased risk for Alzheimer’s disease. There are no sex differences in risk for vascular dementia.
In England, Wales, and Australia, dementia has become the leading cause of death for women. In the US and Australia, women make up 2/3 of all dementia deaths. Over the past 20 years, new dementia cases have dropped by 20% mostly driven by a decrease in incidence among men 65+. This could be due to anti-smoking campaigns – which is a risk factor for Alzheimer’s and men tend to smoke more than women.
Dementia tends to progress faster in women than men. One theory suggests that the drop of estrogen after menopause is a contributing factor as it is believed that estrogen helps protect the brain.
Additionally, dementia can be more advanced in women vs men when diagnosed. This may be since women tend to perform better on the initial tests leading to masking of symptoms and missed diagnoses. Since women might be diagnosed later in the disease, more pathology might already be built up in the brain. As research progresses, the medical community is taking into consideration changing the diagnostic tests to account for the differences between men and women to detect and avoid missed diagnoses.
Although females have a greater risk of developing dementia than men, the overall risk is still low and is not a normal part of aging. Living a brain healthy lifestyle can reduce the risk by almost 75%. Having a regular cognitive assessment can help identify many risk factors and keep you on the path to a Healthy Brain.
We highly recomend annual cognitive evaluations if you are at risk through the Health Aging Brain program, click here to book your evaluation today!
For more information on dementia, visit Alzheimer Society of Canada. You can also find more Honsberger Physio+ blogs discussing Cognitive Health at https://www.honsbergerphysio.com/Blog/
Written by Melisa Luong and Efan Gonsalves.
Both Melisa and Efan are Registered Physiotherapists at Honsberger Physio+ and work with the Healthy Brain program and concussion injuries, as well as orthopedic and sports injuries.