The sex and gender of Alzheimer's disease



Nearly all research projects rely on male animal models even though two thirds of Alzheimer patients are women. 

When it comes to Alzheimer's disease, are men and women on equal footing? No, says Florencia Iulita, postdoctoral fellow in the Laboratory of Cerebrovascular Pharmacology at Université de Montréal. And it's not only because women live longer.

In collaboration with the Women's Brain Project, a Swiss NGO, and the Alzheimer Precision Medicine Initiative, an international panel of clinicians and researchers developing precision medicine for Alzheimer's disease, Florencia Iulita led a comparative review of Alzheimer literature to determine sex-based differences. While the gender issue is rarely addressed, some studies have revealed major variations in risk factors, symptoms and progression. Indeed, Alzheimer's disease may evolve more quickly in women.  

The researcher and laboratory director Hélène Girouard chose to focus on the contribution of vascular factors, including diabetes, high blood pressure, cholesterol and heart disease, which are risk markers for Alzheimer's disease. Heart disease seems to be the earliest vascular manifestation in men, while vascular brain disease such as stroke appears first in women. These findings may have a differential impact on men versus women in terms of their risk of developing the disease. 

The team found that nearly all research projects rely on male animal models even though two thirds of Alzheimer patients are women, and clinical studies tend to consider sex-based differences without making any distinctions. Few initiatives compare the groups, and those that do often do not have a sufficient number of male and female participants to draw clear conclusions.

Florencia Iulita hopes that her observations will raise the alarm on the importance of sex- and gender-based Alzheimer studies and the development of treatment options tailored to men and women.