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Excluding sex, gender hinders progress in Alzheimer’s disease research

Experts recommend that research stop excluding sex and gender in the detection, treatment and care of Alzheimer’s disease to improve outcomes for women and men, according to a review published in Alzheimer’s & Dementia.

“To maximize the development of current and future treatments and interventions across the [clinical] spectrum, sex and gender differences in [Alzheimer’s disease] must be better understood and measured,” Rebecca A. Nebel, PhD, from the Scientific Programs, Society for Women’s Health Research, and colleagues wrote. “By this, we mean that studies of female/male differences in [Alzheimer’s disease] should focus not only on biological sex but also on gender differences in factors such as education, caregiving, and other gender roles, as well as mental health factors where both biological and social factors contribute to female/male differences.”

Experts from the Society for Women’s Health Research (SWHR) Interdisciplinary Network on Alzheimer’s Disease reviewed ongoing and published research related to sex and gender differences in Alzheimer’s disease to identify the gaps in clinical research. After reviewing the current clinical evidence, the experts created a list of 12 high-priority recommendations that warrant further research on sex and gender differences in Alzheimer’s disease.

Future research should investigate:

• the extent to which differences in longevity, survival bias and comorbidities impact sex and gender differences in Alzheimer’s disease;

• potential sex-specific risk factors like pregnancy and menopause for women and testosterone loss for men;

• estrogens and hormone therapy influence on brain function and disease risk;

• possible sex differences in genetic risk factors like in the cases of APOE 4 carriers;

• risk factors observed in both sexes like cardiovascular disease, diabetes, education and depression;

• sex differences in disease progression and change in cognitive function, neuroimaging, cerebrospinal fluid and biomarkers;

• whether sex differences in brain development impacts sex differences in brain aging and disease pathology;

• racial and ethnic differences;

• societal, political and geographical changes in estimates of sex differences in Alzheimer’s;

• gender differences in caregiving;

• variances in the development of therapeutics in preclinical and clinical studies, as well as in designing clinical trials; and

• differences on clinical detection, diagnosis, management and treatment of Alzheimer’s disease for men and women.

Pauline M. Maki

“A growing body of research shows us that Alzheimer’s disease differs between women and men,” Pauline M. Maki, PhD, chair of the SWHR Network on Alzheimer’s Disease, said in a press release. “To improve the diagnosis of the disease and to speed the development of new treatments and interventions, we must better understand how the biological and sociocultural differences between women and men are influencing the development, progression, and treatment of Alzheimer’s.” – by Savannah Demko

Disclosure: The researchers report this work was supported by Eli Lilly & Co.