Dementia May Look Different For Women Than Men

For reasons we don’t fully understand yet, most people with dementia (about 65%) are women.

That might be because women live longer than men – old age is the number one risk factor for dementia. Some think that hormonal changes, including menopause, as well as differences in known risk factors, such as spending fewer years in education compared to men, might contribute to the discrepancy, too.

And now, a paper from the Montreal Neurological Institute at McGill University has suggested that some common verbal tests used to help diagnose dementia could be leaving women undiagnosed for 2.7 years longer.

Verbal memory tests such as the Rey’s Auditory Learning Test (RAVLT), which tests how well people remember lists of words in both immediate and delayed settings, are “widely used in Alzheimer’s disease assessments”, the paper said.

But the researchers think women, on average, have better verbal memory. Their study suggests that women keep that “advantage”, even when their brains are facing as many Alzheimer’s-related brain changes as men.

So, the study authors wanted to see whether “this form of cognitive reserve masks symptoms and delays diagnosis in females”.

They found that compared to men whose brains appeared to be in the same stage of dementia development, women kept healthy verbal memory for about 2.7 years longer.

That might leave them undiagnosed for longer. “This masked period represents a window for earlier detection and timely intervention before irreversible neurodegeneration,” the authors wrote.

After that 2.7-year point, the cognitive abilities of women with dementia-related brain changes seemed to decline 25-50% faster than men’s.

Typically, the study suggested, this is when tests begin to pick up the condition among women.

On their site, Alzheimer’s Society said that “the vast majority of experiments and clinical trials carried out by dementia researchers have not been designed to see differences between male and female participants”.

But we know that women have both different possible risk factors (including hypertensive pregnancy disorders) and symptoms (women with dementia are more likely to report anxiety and depression).

The charity added that this means we still have a “poor understanding of how diseases causing dementia might work differently in females,” and that it might take us a while to catch up.