Sex and gender differences in Alzheimer’s disease: current challenges and implications for clinical practice

Post Written By: Benedetta Romeo

In individuals with type 2 diabetes (T2DM) and obesity, cognitive impairment seems to differ between men and women. Despite similar lifestyle and clinical risk factors, these differences remain, with women showing a notably lower prevalence of cognitive impairment than men.

In this study, we examine potential factors contributing to these differences and how they might help us in finding better prevention strategies.

Key observations:

  1. Cognitive impairment (mild cognitive impairment or dementia) was 30% lower in women than men. This could not be explained by differences in risk factor profiles, intervention assignment or adherence, or how T2DM was treated and controlled over time. However, these differences were attenuated among APOE-ɛ4 carriers
  2. Women outperformed men in verbal memory, processing speed, and general cognitive assessments. Notably, this difference persisted across age groups, indicating potential sex-based resilience mechanisms in cognitive aging
  3. Lifestyle interventions aimed at diabetes management did not alter cognitive differences between sexes. Both men and women benefited similarly, suggesting that male sex might independently elevate cognitive impairment risk in this population
  4. Understanding the biological and hormonal mechanisms, including potential estrogen and testosterone effects, could provide help for tailored interventions to reduce cognitive risks among diabetic patients

Check our publication here: Sex-related differences in the prevalence of cognitive impairment among overweight and obese adults with type 2 diabetes

A big thank you to everybody who contributed to this article: Mark A. Espeland, Owen Carmichael, Sevil Yasar, Christina Hugenschmidt, William Hazzard, Kathleen M. Hayden, Stephen R. Rapp, Rebecca Neiberg, Karen C. Johnson, Siobhan Hoscheidt, Michelle M. Mielke, and for the Action for Health in Diabetes (Look AHEAD) Research Group