Resistance to Alzheimer’s disease varies by gender and sex

Experts are calling to take these differences into account sex in future Alzheimer’s research. The work is published in Alzheimer’s Disease and Dementia: Journal of the Alzheimer’s Association .

Women make up the majority of people with Alzheimer’s disease and they have double your risk over your lifetime The prevalence of protective and risk factors and the burden of pathology associated with Alzheimer’s disease and related conditions such as cerebrovascular disease differ by sex and gender due to biological factors (eg, genetic risk) and social factors (eg, education and lifestyle).

“Assessing how sex and gender interact is critical to understanding mechanisms that support cognitive functions and reduce the accumulation of pathologies in aging and Alzheimer’s disease, that is, factors of resilience and sustainability,” he says. Gaga Arenas-Urquijo ISGlobal researcher, first author of the study, and president of the Alzheimer’s Association’s Reserve, Resilience, and Protective Factors Group.

Resistance and resistance to Alzheimer’s disease in men and women

Based on a review of a large body of literature, the team identified sex and gender differences in dementia risk and found gap in understanding specific risk and resilience pathways .

Although women tend to have an initial cognitive advantage, this deteriorates more rapidly than men as the disease progresses. This may be due to the differential development of pathologies known as resistance to Alzheimer’s disease or other ability to maintain normal functioning over time and cope with pathology once it occurs, known as cognitive resilience to Alzheimer’s disease.

In fact, women show initially greater resilience, a better ability to cope with pathologies and brain atrophy, and maintain cognitive function. Women’s greater initial resilience is supported by animal studies showing a protective role for the X chromosome in Alzheimer’s disease (women typically have two X chromosomes, while men have one). However, this Initial stability weakens as progress in clinical diagnosis mild cognitive impairment and Alzheimer’s disease, where they exhibit greater vulnerability. In fact, studies show that women are more likely to have abnormal accumulation of tau protein in the brain and exhibit a greater burden of vascular pathologies, especially after menopause.

The authors propose various mechanisms to explain the differences in risk and resilience between women and men, including higher prevalence of physical inactivity and affective disorders in women but also biological factors. In this sense, genetic data suggest that resistance may be related to immune pathways in women

And on the cardiovascular system in men.

Eliminate changeable factors

According to the research team, studies of resilience in Alzheimer’s disease have focused primarily on individual behavior without taking into account how social and cultural factors like the floor, influence behavior and therefore risk and resilience . It is important to note that differences in cognitive function between men and women may decrease as Gender inequality is also decreasing by increasing women’s educational opportunities, labour force participation and improving their economic status and living conditions. “Protective factors such as education may affect men and women differently. “We need to understand the complexity of the interaction between biological and social factors to understand resilience to Alzheimer’s disease,” he says. Arenas-Urquijo .

For this reason, the authors advocate gender sensitive approach to sustainability better understand the complex interplay of biological and social determinants. “Greater attention to the differential impact of modifiable factors will help determine whether a particular factor has a greater impact on cognitive or brain resilience in men or women,” Arenaza-Urquijo says.

Recommendations for future research

To improve our understanding of how sex and gender influence cognitive resilience to aging and Alzheimer’s disease, the researchers recommend several directions for future research. First, they highlight the need to study How Sex and Gender Interact in Different Cultures taking into account demographic, genetic, social and clinical differences that influence the risk of developing dementia.

They note that sex/gender differences in brain characteristics Factors such as brain connectivity remain understudied as resilience factors in Alzheimer’s disease that may minimize the impact of pathologies on cognition.

The authors also argue that Publication of negative results is crucial to avoid bias and to ensure that all studies include results disaggregated by sex. Finally, they point to the importance of considering sex and gender in a non-binary way, as well as include LGTBIQ+ populations who are often underrepresented and face a high burden of chronic diseases.

Link:

Arenas-Urquijo EM, Boyle R, Casaletto K, Ansteri K, Vila-Castelar K, et al. Sex and Gender Differences in Cognitive Resilience to Aging and Alzheimer’s Disease. Alzheimer’s disease and dementia. Doi: 10.1002/alz.13844

Source: IS Global