A recent comprehensive study reveals that gender-based social and economic disadvantages may be to blame for the fact that more women than males are affected by dementia worldwide.
According to a meta-analysis of 21 international st,udies including 29,850 people from 18 countries, gender inequality appears to have a substantial role in deciding who develops dementia and who does not, rather than sex, average lifespan, and other biological characteristics alone.
The study was published on February 15 in the Journal of the Alzheimer’s Association. 58 percent of the patients tested were female, none had dementia at the outset of the study, and 2,089 were diagnosed with dementia during the later follow-up. Between 0.01 and 19.6 years passed between study initiation and follow-up, depending on the patients and the studies in which they participated.
While men were more likely to have smoked in their lifetimes, consumed alcohol during the research period, and engaged in vigorous physical activity, women had less years of schooling and were more likely to have experienced depression in their lifetimes. In addition, they accounted for 66% of dementia cases identified during the course of the study. Average participant age at the beginning of the trial was 72 years for women and 71 years for men.
The study also indicated that people of color and those living in nations with low to low-middle incomes were more likely to suffer from dementia. The George Institute for Global Health’s Jessica Gong, the study’s lead author, stated that the findings contradict prior studies that claimed women have a higher risk of acquiring dementia than males because they live longer on average.
Gong stated in a press release, “The majority of research predicting dementia incidence to far has been undertaken in high-income nations, with relatively few data available in the countries that actually face the largest burden.”
“After adjusting for age, we discovered that dementia rates were highest in low- to low-middle-income nations, and greater in women than in males.” According to the report, the number of individuals living with dementia is predicted to approach 150 million by 2050, which is three times the 2019 projection of 50 million, and the rate of increase is greatest in low- and middle-income nations.
Gong stated that she and her co-authors drew inspiration for their study from the 2020 Lancet Commission Report, which indicated that as much as 40% of dementia risk could be related to 12 modifiable risk factors, many of which are more prevalent in low- and middle-income countries.
They include a lack of education, hypertension, obesity, diabetes, depression, hearing loss, smoking, excessive alcohol use, physical inactivity, low social contact, traumatic brain damage, and air pollution. “Older age, diabetes, depression, hearing impairment, and the genetic variant APOE4 implicated in fat metabolism in the brain were all related with an increased risk of dementia in both men and women,” Gong added.
“More years of schooling, a larger hip circumference, current alcohol consumption, and vigorous physical exercise were associated with a decreased risk of dementia in both sexes. Nonetheless, there was moderate evidence of a gender difference in relation to years of schooling, suggesting a larger protective link for males than for women.”
Gong and her co-authors discovered that women, especially in low- and middle-income nations, do not have equal access to characteristics that protect against dementia, such as greater levels of schooling and intellectually challenging work.
Sanne Peters, a member of the research team and senior lecturer at the George Institute for Global Health U.K., explained that factors limiting women’s opportunities, barriers to appropriate health care, and other factors such as domestic violence can lead to psychological stress and financial instability, particularly among women from lower socioeconomic settings. In turn, these outcomes impact the cognitive health of older women.
Peters stated in a press statement, “In general, the geographical patterns we saw for greater dementia risk in women appeared to mirror those of gender inequality.” “Our findings justify support for programs to increase gender equity in brain health throughout the life course, especially in populations that have been underrepresented in dementia research in the past.”