Depending on what you read, the risk of developing Alzheimer’s in the United States and other wealthy Western countries is declining. However, due to the growing older adult population, the number of people living with Alzheimer’s is expected to increase dramatically. In the United States in 2010 there were 454,000 new cases of Alzheimer’s disease. By 2050, there is expected to be close to a million. Will most of them be women? That depends.
I had always assumed that the reason Alzheimer’s affects more women than men is because women lived longer. And because the incidence of Alzheimer’s is directly correlated with aging, that just made sense.
Then I learned that even accounting for the extra years of life, women over 65 years old still have an increased risk (1 in 6) of developing Alzheimer’s versus men (1 in 11). Then I read something about the protective role of estrogen and mitochondrial function, and the possible increased susceptibility to Alzheimer’s due to hormone loss after menopause. Ah, yes that must be it- hormones and aging. Bingo.
But then I heard Dr. Marie Pasinski talking about modifiable risk factors for Alzheimer’s disease… and now I’m all fired up.
We all know that times are changing. Women are feeling more empowered and in control of their lifestyles and behaviors than ever before. But looking back on previous generations, women did not have the same opportunities as men. And those lifestyle differences, we now see, are shown to be risk factors for Alzheimer’s disease. The roles of women were limited and not “modifiable” in generations past… but they are now. Why are women age 65 and older now being diagnosed with Alzheimer’s disease at a higher rate than men? Perhaps these risk factors, which are now leveling off as each subsequent generation of women enjoys more rights and freedoms, are responsible for today’s higher numbers:
- Risk Factor #1: Higher Education. One of the biggest risk factors for Alzheimer’s disease is higher education, and the lack of education opportunities for women compared to men has been an historical, worldwide disparity. Higher education also leads to higher level jobs opportunities, and more exposure to complex cognitive demands. It wasn’t until the Civil Rights movement propelled women’s rights forward when more women started to pursue advanced degrees. By 1979, more women began enrolling in higher education than men in the United States (Touchton). In 2014, 30.2% of women had a bachelor’s degree, compared to 29.9% of men (Feeney). But prior to this? Women were not educated to the extent men were, and the cognitive demands of their homemaker roles were significantly less intense than the working man’s.
- Risk Factor #2: Physical Exercise. Another hefty risk factor for Alzheimer’s disease is lack of exercise, and the practice of physical activity was sorely lacking among the women in my mother’s generation. “Physical fitness” belonged to men. Sweaty, competitive, and muscle-bulking activity was not considered “feminine”. Sports designed for girls were hardly challenging or strenuous. But now, women dominate the fitness industry. More women enroll and complete half-marathons than men. More women attend group fitness classes and use wearable tracking devices than men. Women are now raising girls who compete in physically demanding sports year round; girls who are highly motivated to achieve maximum physical performance. These girls have already reduced their chances of developing Alzheimer’s disease.
- Risk Factor #3: Sleep deprivation… now there is a risk factor many women are just stuck with. Women do the majority of caregiving- for the babies and for the elders- and often while still working. Stress compounds sleep deprivation. Hormonal changes compound sleep deprivation. If a woman does not develop Alzheimer’s disease over the course of her life, chances are she will care for someone who does.
After billions of dollars spent and hundreds of failed experiments, it may be the case that reducing the risk of Alzheimer’s disease may never be found in a vaccine, medication, or supplement. Knowing what modifiable risk factors are present and investing in the elimination of those risk factors is probably a more productive use of resources. Reducing the incidence of Alzheimer’s worldwide- across both genders- is possible by investing in the support and success of women. Women who are educated, physically fit, and supported in the home have a better chance for an Alzheimer’s-free future and can better provide support for others who don’t.