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Emerging Research Suggests Why Women Face Higher Dementia Risk Than Men

Photo: Courtesy of TED

When Dr. Lisa Mosconi was weighing her career options, she knew one thing: she wanted it to involve the brain.

Mosconi, who is from Florence, Italy, came from a family of scientists, after all. After she settled on neuroscience, her life’s work took on new meaning when her grandmother, and eventually her grandma’s two sisters, developed Alzheimer’s disease — the most common form of dementia — and died. 

She knew Alzheimer’s was more common in women than men, accounting for 2 in 4 cases, but she began to wonder why — not only because of her interest in neuroscience, but for the sake of her and her family members’ health.

“I was incredibly concerned,” said Mosconi, director of the Weill Cornell Women’s Brain Initiative and author of the books “Brain Food” and “The XX Brain.” “My aunts, my cousins, everybody was really panicking because the question was, ‘Is it genetic? Does it attack women preferentially? Does it run in families?’ and if so, are we destined to get Alzheimer’s ourselves? Can we do something to prevent it? Or delay or avoid it? And when I started asking questions about this, nobody had answers.”

Mosconi was determined to find out, and her discovery is helping change the way people think about Alzheimer’s, particularly in women, and how health habits may help keep the disease at bay. 

The menopause link

Two common beliefs are that getting Alzheimer’s is out of your control because it’s written in your genes, and that more women develop Alzheimer’s than men because women tend to live longer. But through her studies, Mosconi pointed out in the vast majority of cases — 98 percent — there’s no clear genetic mechanism involved. Also, she has found brain changes that eventually lead to dementia begin in midlife. 

“So what happens to women, and not to men, in midlife that could potentially trigger Alzheimer’s disease or increase the risk?” she pondered.

That’s how her team landed on menopause. In women as young as in their 40s, brain scans show amyloid plaques, which are linked to Alzheimer’s, Mosconi said. It may be connected to the loss of estradiol, the most powerful form of estrogen, which is a hormone responsible for essential neural function. 

“Most importantly, estrogen relaying is key for brain activity and brain energy,” she said.

Connecting the dots

Most neurologists and OB-GYNs aren’t talking about this, and specialists, such as gastroenterologists, aren’t communicating with them either. However, they should be, Mosconi argued, because it’s all connected. 

Prevention is another topic worthy of discussion, and both men and women can start developing healthy habits now, as early as their 20s or 30s, to help prevent or delay future dementia. Mosconi recommended: 

  • Eating a natural, whole foods-based diet 
  • Limiting or avoiding processed food high in unhealthy fat, sugar, and refined carbohydrates
  • Exercising regularly
  • Monitoring all aspects of your health, including hormonal and heart, with the help of a well-rounded healthcare team.

“I think it’s really important to this holistic understanding of the body as an organism, rather than a number of bits and pieces that magically turn into a person,” Mosconi said. “For so long, modern medicine really did not believe that lifestyle had any possible impact on brain health. And now there are clinical trials showing the opposite.”

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