Consideration of sex and gender in Alzheimer's disease and related disorders from a global perspective

Michelle M. Mielke, Division of Epidemiology, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, USA.
Neelum T. Aggarwal, Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois, USA.
Clara Vila-Castelar, Department of Psychiatry, Harvard Medical School, Massachusetts General Hospital, Massachusetts, Boston, USA.
Puja Agarwal, Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois, USA.
Eider M. Arenaza-Urquijo, Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain.
Benjamin Brett, Department of Neurosurgery, Medical College of Wisconsin, Wisconsin, Milwaukee, USA.
Anna Brugulat-Serrat, Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain.
Lyndsey E. DuBose, Department of Medicine, Division of Geriatrics, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.
Willem S. Eikelboom, Department of Neurology, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
Jason Flatt, Social and Behavioral Health Program, School of Public Health, University of Nevada, Las Vegas, Las Vegas, Nevada, USA.
Nancy S. Foldi, Department of Psychology, Queens College and The Graduate Center, City University of New York, New York, USA.
Sanne Franzen, Department of Neurology, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
Paola Gilsanz, Kaiser Permanente Division of Research, Oakland, California, USA.
Wei Li, Department of Clinical and Diagnostic Sciences, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Alison J. McManus, Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts, USA.
Debora Melo van Lent, UT Health San Antonio, Glenn Biggs Institute for Alzheimer's and Neurodegenerative diseases, San Antonio, Texas, USA.
Sadaf Arefi Milani, Division of Geriatrics & Palliative Medicine, Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas, USA.
C Elizabeth Shaaban, Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Shana D. Stites, Department of Psychiatry, Perlman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Erin Sundermann, Department of Psychiatry, University of California, San Diego, California, USA.
Vidyani Suryadevara, Department of Orthopedic Surgery, Rush University Medical Center, Chicago, Illinois, USA.
Jean-Francoise Trani, Department of Public Health, Washington University in St. Louis, St. Louis, Missouri, USA.
Arlener D. Turner, Department of Psychiatry & Behavioral Sciences, University of Miami Miller School of Medicine, Miami, Florida, USA.
Jet M. Vonk, Taub Institute for Research on Alzheimer's Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, New York, USA.
Yakeel T. Quiroz, Department of Psychiatry, Harvard Medical School, Massachusetts General Hospital, Massachusetts, Boston, USA.
Ganesh M. Babulal, Department of Neurology, Washington University in St. Louis, St. Louis, Mississippi, USA.

Document Type

Journal Article

Publication Date

4-8-2022

Journal

Alzheimer's & dementia : the journal of the Alzheimer's Association

DOI

10.1002/alz.12662

Keywords

Alzheimer's; ethnicity; gender; global health; risk factors, sex; sociocultural factors

Abstract

Sex or gender differences in the risk of Alzheimer's disease and related dementias (ADRD) differ by world region, suggesting that there are potentially modifiable risk factors for intervention. However, few epidemiological or clinical ADRD studies examine sex differences; even fewer evaluate gender in the context of ADRD risk. The goals of this perspective are to: (1) provide definitions of gender, biologic sex, and sexual orientation. and the limitations of examining these as binary variables; (2) provide an overview of what is known with regard to sex and gender differences in the risk, prevention, and diagnosis of ADRD; and (3) discuss these sex and gender differences from a global, worldwide perspective. Identifying drivers of sex and gender differences in ADRD throughout the world is a first step in developing interventions unique to each geographical and sociocultural area to reduce these inequities and to ultimately reduce global ADRD risk. HIGHLIGHTS: The burden of dementia is unevenly distributed geographically and by sex and gender. Scientific advances in genetics and biomarkers challenge beliefs that sex is binary. Discrimination against women and sex and gender minority (SGM) populations contributes to cognitive decline. Sociocultural factors lead to gender inequities in Alzheimer's disease and related dementias (ADRD) worldwide.

Department

Clinical Research and Leadership

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