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Sex and gender considerations in dementia: a call for global research

Nature Aging volume 3, pages 463–465 (2023)Cite this article

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Studies have identified sex and/or gender differences in Alzheimer’s disease, but few have examined other dementias. We highlight sex and gender differences in other dementias, discuss sociocultural factors and provide a framework for future global studies.

Several studies from Europe and Asia have suggested that women have a higher incidence of Alzheimer’s disease (AD) than men, according to a recent perspective1. By contrast, studies conducted in North and South America have not typically reported sex or gender differences in the incidence of AD. These globally disparate results suggest relevant social, cultural, demographic and historical factors that vary by sex or gender and contribute to AD risk. Indeed, sex and gender differences in AD risk factors have been identified, and include depression, diet, physical activity, cardiometabolic factors and sleep disorders1. Sex-specific conditions also affect AD risk, including hypertensive disorders of pregnancy or early menopause and menopausal hormonal therapy for female individuals, and prostate cancer or androgen deprivation therapy for male individuals2. Notably, the prevalence of these risk factors varies across races and ethnicities, cultures, and global regions. Sociocultural aspects that lead to gender inequities (for example, access to education, employment or occupation characteristics, healthcare access and discrimination) also increase the risk of AD. There is a critical need to understand the intersection of sex-related factors, sociocultural gender roles and race and ethnicity for risk of AD globally, particularly in low- and middle-income countries.

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Fig. 1: Proposed framework to investigate sex and gender differences in AD and non-AD dementias globally.

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Acknowledgements

C.V.-C. receives funding from the National Institute on Aging (NIA) K99AG073452. M.M.M. receives funding from the National Institute on Aging (RF1 AG055151, U54 AG044170, RF1 AG077386; RF1 AG079397). C.U.-M. is funded by Janssen R&D, Gates Ventures, Takeda and Merck, and received project grants from the RoseTrees Foundation Trust, Alzheimer Research UK and the British Society for Neuroendocrinology.

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Authors and Affiliations

  1. Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA

    Clara Vila-Castelar

  2. Ageing Epidemiology (AGE) Research Unit, School of Public Health, Imperial College London, London, UK

    Chinedu Udeh-Momoh

  3. Department of Neurobiology, Care Sciences and Society (NVS), Division of Clinical Geriatrics, Karolinska Institute, Stockholm, Sweden

    Chinedu Udeh-Momoh

  4. Global Brain Health Institute (GBHI), University of California, San Francisco, CA, USA

    Chinedu Udeh-Momoh

  5. Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA

    Neelum T. Aggarwal

  6. Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, USA

    Neelum T. Aggarwal

  7. Department of Epidemiology and Prevention, Wake Forest University School of Medicine, Winston-Salem, NC, USA

    Michelle M. Mielke

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  1. Clara Vila-Castelar
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  2. Chinedu Udeh-Momoh
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  3. Neelum T. Aggarwal
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  4. Michelle M. Mielke
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Corresponding author

Correspondence to Michelle M. Mielke.

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Competing interests

M.M.M. has served on scientific advisory boards and/or has consulted for Biogen, LabCorp, Lilly, Merck, PeerView Institute, Siemens Healthineers, and Sunbird Bio unrelated to the current manuscript. The other authors declare no competing interests.

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Nature Aging thanks Maria Carmela Tartaglia and the other, anonymous, reviewer(s) for their contribution to the peer review of this work.

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Vila-Castelar, C., Udeh-Momoh, C., Aggarwal, N.T. et al. Sex and gender considerations in dementia: a call for global research. Nat Aging 3, 463–465 (2023). https://doi.org/10.1038/s43587-023-00374-5

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