While this might not be obvious initially, research has shown that more women develop dementia in their lifetimes than their male counterparts. Globally, women with dementia outnumber men 2 to 1. Clearly, dementia is different for women, but why is that? Biological factors contribute to why more women develop the condition than men however women are also disproportionately impacted indirectly by the condition as they are more often caregivers of people with dementia. A look at biological and societal factors makes it evident why looking at dementia through a gender lens is necessary to find an approach to the condition that caters to both the male and female experience.
Biological factors
Age
Age is one of the main risk factors for dementia and accounts for a large portion of the gender disparity. The likelihood of developing late-onset Alzheimer’s increases with age. Dementia affects more women than males since they often live longer. Thus, the fact that there are 5.7 million more older women than older males in our society and that Alzheimer’s disease is more prevalent in older people is one of the reasons why more women than men have the disease. Age also contributes in another way. For older women, ageism and genderism can often lead to them experiencing stigmas and even abuse because of their condition, even more so than their male counterparts.
Amyloid
According to Harvard Medical School, another contributing factor to more women developing Alzheimer’s could be amyloid deposits in our immune system. Amyloid, a component of Alzheimer’s disease pathology, assists in fighting off infections in the brain. It forms part of the brain’s immune system to fight off infections; incidentally, women are twice as likely to have an autoimmune disease. This could be a result of many autoimmune diseases being more common during pregnancy. Women may end up having more amyloid plaques than men, leaving them at a greater risk of developing Alzheimer’s than men due to this amyloid protein clumping together to form Alzheimer’s.
However, there is something that can be done to lower this risk factor, and it’s simpler than you’d think – sleep. We all produce some of this amyloid protein in the day. However, brain connections and cell size decrease during sleep. Because of this shrinkage, there is more room between brain cells, allowing beta-amyloid and other compounds that build up throughout the day to be washed away.
Oestrogen
Why the illness advances more quickly in women than in males following diagnosis is an essential subject for researchers. According to one school of thinking, oestrogen protects women’s brains while they are still young, but after a certain age, both these advantages and oestrogen levels decline.
The growth and function of a woman’s brain are influenced by oestrogen. According to researchers, this may explain why women have a stronger recall for words and linguistic information than males. When diagnosing Alzheimer’s, the recall of a word list or a short tale is tested to gauge this aspect of memory.
Although some women may be on the onset of Alzheimer’s, they do better on these initial tests, which can cause early diagnoses to be overlooked and may also cause medical professionals to overestimate the severity of the condition. In that instance, it could be necessary to modify diagnostic tests to account for the neuropsychological variations between men and women. Due to the possibility that their verbal memory abilities are less developed, males are more prone to receive a false diagnosis of dementia, and women might seem fine even though they have early-stage dementia.
According to Professor Patrick Kehoe, an Alzheimer’s researcher based at the University of Bristol, a woman’s chance of acquiring Alzheimer’s may be influenced by the intricate interactions between oestrogen and the renin-angiotensin system controls blood pressure and has a role in cognitive function. After menopause, a woman is more likely to develop high blood pressure and maybe dementia due to the effects of oestrogen on this system. However, further research is required to confirm this.
Societal factors
Gender Norms
On the socio-economic side, there’s no doubt that women provide the bulk of dementia and Alzheimer’s care. Therefore each woman’s interaction with dementia is unique. Socialised gender norms can also filter into the prevalence of dementia amongst women.
According to Women and Dementia: A Global Challenge, “Early cognitive development and education have a preventive effect on developing dementia later in life. In many countries, women are less likely than men to have access and the opportunity to take up much education. Young girls are frequently removed from schooling at an earlier age than boys (Ochayi and Thacher, 2006). Adolescent girls are also often less physically active than their male counterparts, possibly due to societal expectations of male and female genders, exposing them to key risk factors for developing dementia later in life (WHO Regional Committee for Europe, 2016a).”
Care
For women with dementia, the transition from caregiver to care receiver can be emotionally distressing. A woman’s role as a caring partner in a traditional family structure may be a distinguishing quality in many countries. If a woman identifies primarily as a caregiver, she may resist change and be less likely to ask for assistance or accept support when it is offered if she begins to show signs of dementia.
Another part of women’s interaction with dementia comes from the fact that women are most often the caregiver. While being a caregiver can be a rewarding and fulfilling experience, it can often result in mental, physical and economic problems, especially when it’s an unpaid expectation which often happens to daughters and other female family members of those living with dementia. Even the formal dementia care workforce around the work is predominately female.
Looking at dementia through a gender lens makes evident a lot of challenges that aren’t always clear in the first place. Considering all of the above, it’s hard to believe that it isn’t widespread to have gender-sensitive approaches to dementia, both in policy and in action. If the experience of dementia differs for men and women, why aren’t both scenarios considered? The future of dementia needs to address gender gaps and present solutions that cater to specific experiences that men and women have with dementia.
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