Women not only experience a higher burden of certain dementia risk factors, but also appear more vulnerable to their effects on cognitive function, according to a new study led by Megan Fitzhugh and Judy Pa of the University of California, San Diego School of Medicine.
For their study, the authors evaluated 13 established, modifiable dementia risk factors among more than 17,000 middle-aged and older adults from the Health and Retirement Study. Ten of those risk factors had sex differences in prevalence; women were more likely to report elevated cholesterol, depression, physical inactivity, smoking, poor vision, and poor sleep. Women also had fewer years of education. On the other hand, men had a higher prevalence of hearing loss, diabetes, and excessive alcohol use. Overall, hypertension was common in both groups and average body mass index for both sexes fell in the overweight-to-obese range.
Beyond prevalence, certain risk factors were more strongly associated with poorer cognitive performance in women. Conditions such as hypertension and increased BMI showed steeper negative associations with cognition in women compared to men. Hearing loss and diabetes, two factors more common in men, were linked to poorer cognitive scores in women.
“These differences highlight the importance of considering sex as a key variable in dementia research,” said Dr. Pa. “Sex differences are profoundly overlooked among many leading causes of death like Alzheimer’s, heart disease and cancer.”
Going forward, the authors call on future research to investigate the biological and social mechanisms driving sex-based differences in dementia risk factors.
“Ultimately, a more nuanced understanding of these differences could help us design smarter, more targeted interventions,” said Dr. Fitzhugh. “That’s an essential step toward reducing the burden of dementia for everyone, but especially for women, who are disproportionately affected.”
Dr. Pa is a professor of neurosciences, the Shiley Endowed Chair of Alzheimer’s Disease Research, and co-director of the Alzheimer’s Disease Cooperative Study at UC San Diego. She earned her Ph.D. in cognitive neuroscience from the University of California, Irvine and completed postdoctoral research in neurodegenerative diseases at the University of California, San Francisco.
Dr. Fitzhugh is an assistant professor of neurosciences and active collaborator of the Pa Lab. She earned her bachelor’s and master’s degrees in physiology and psychology from the University of Arizona and her doctorate in neuroscience from Arizona State University.