The puzzle of sex, gender and Alzheimer’s disease: Why are women more often affected than men?

IF 2.7 Q2 OBSTETRICS & GYNECOLOGY

Womens Health Pub Date : 2018-12-01 DOI:10.1177/1745506518817995

M. Andrew, M. Tierney

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引用次数: 67

Abstract

Objective: There are impressive differences in the incidence, prevalence and experience of women and men with Alzheimer’s Disease (AD). Notably, two-thirds of those with AD, the most common form of dementia, are women. Our objective was to provide a literature-based framework to understand these sex and gender differences in AD. Methods: We conducted a narrative review to examine sex and gender influences on AD. Results: We present a framework to understanding why these sex and gender differences exist in AD. This includes the influence of longevity (women live longer than men), biological differences (hormonal differences, epigenetics and frailty), differences in cognitive performance (women and men tend to perform differently on some cognitive tests), and gendered social roles and opportunities (educational and occupational opportunities, functional roles post-retirement). Our review clearly indicates the complex interaction of these sex and gender differences and variability within each. Conclusions: Given these important sex and gender differences in AD, we provide recommendations and steps forward describing how both sex and gender should be considered in dementia diagnosis and management and in the design and implementation of dementia research, including studies of caregiving interventions and models of dementia care.

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性、性别和阿尔茨海默病的谜团:为什么女性比男性更容易受到影响?

目的：女性和男性阿尔茨海默病（AD）的发病率、患病率和经历存在显著差异。值得注意的是，三分之二的AD（最常见的痴呆形式）患者是女性。我们的目标是提供一个基于文献的框架来理解AD中的这些性别和性别差异，生物学差异（荷尔蒙差异、表观遗传学和虚弱）、认知表现差异（女性和男性在某些认知测试中的表现往往不同）以及性别社会角色和机会（教育和职业机会、退休后的功能角色）。我们的综述清楚地表明了这些性别和性别差异之间的复杂相互作用以及每种差异之间的可变性。结论：鉴于AD中存在这些重要的性别和性别差异，我们提出了一些建议和步骤，说明在痴呆症诊断和管理以及痴呆症研究的设计和实施中，包括护理干预和痴呆症护理模式的研究中，应如何考虑性别和性别。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Womens Health OBSTETRICS & GYNECOLOGY-

CiteScore

2.80

自引率

4.20%

发文量

审稿时长

15 weeks

期刊介绍： For many diseases, women’s physiology and life-cycle hormonal changes demand important consideration when determining healthcare management options. Age- and gender-related factors can directly affect treatment outcomes, and differences between the clinical management of, say, an adolescent female and that in a pre- or postmenopausal patient may be either subtle or profound. At the same time, there are certain conditions that are far more prevalent in women than men, and these may require special attention. Furthermore, in an increasingly aged population in which women demonstrate a greater life-expectancy.