Understanding and Preventing Alzheimer’s in Women

Women’s brain health is a vastly understudied area of medicine, and while men and women do not differ much in terms of brain structure, the differences in brain function are numerous. A woman’s brain carries many different risk factors compared to men, notably making them more susceptible to developing Alzheimer’s disease. Understanding the various factors at play in the development of Alzheimer’s in women, and making certain changes in lifestyle, could help in the prevention of such diseases.

According to Dr. Lisa Mosconi, the director of the Women’s Brain Initiative and associate director of the Alzheimer’s Prevention Clinic at Cornell Medical College, women develop Alzheimer’s at double the rate of men. This increased risk is associated with a variety of genetic factors, including higher levels of estrogen and progesterone, while men produce higher levels of testosterone.

These sex hormones have been shown to affect energy production in the brain, such that the higher the level of these hormones there are in the brain, the higher the brain’s energy production. In turn, lower brain energy levels are associated with a higher risk of Alzheimer’s disease. While men’s testosterone levels may slowly decrease as they age, brain scans in women before and after menopause, which rapidly decreases a women’s estrogen and progesterone levels, show, on average, a 30% decline in brain energy levels.

Another genetic factor associated with Alzheimer’s disease is the APOE gene,  present on chromosome 19. It is involved in cholesterol metabolism and comes in several different forms, called alleles. Each individual inherits one APOE allele from each parent which, depending on the alleles you inherit, can affect the risk of developing Alzheimer’s.  

While understanding genetic predisposition to Alzheimer’s in women is important, lifestyle choices are crucial.

While genetic factors contribute to the development of Alzheimer’s disease, lifestyle choices made early on in life may carry a greater impact overall. Contrary to popular belief, Alzheimer’s disease is not a disease of old age, but starts with changes in the brain years prior to the manifestation of symptoms, which, in women, are then compounded by menopause. By minimizing harmful effects associated with different lifestyle choices, women reduce their chance of developing Alzheimer’s.

Diet, exercise, and sleep are all strongly associated with an individual’s risk of Alzheimer’s. Research has shown that a healthy, well-balanced diet, with some supplementation, can be especially helpful. Carbohydrates from fruits and vegetables, fiber, soy, and foods containing lignans like sesame seeds, dried apricots, and legumes all have a positive effect on sex hormones and, therefore, brain energy production. Similarly, since the APOE gene is involved in cholesterol metabolism, an individual’s insulin resistance, which is affected by dietary choices such as sugar intake, may also be related to Alzheimer’s. Dr. Mosconi suggests that taking supplements can help women’s brain health, although it cannot replace a healthy diet.

Studies have shown that exercise can vastly improve brain function and memory, and women who were more active in midlife have a 30% lower chance of developing Alzheimer’s. Sleep is also imperative to preserving brain function and preventing Alzheimer’s.

So, while understanding genetic predisposition to Alzheimer's in women is important, lifestyle choice are crucial to maintaining brain health and combating degenerative disease.