Sex/Gender Differences in Dementia and Alzheimer’s Disease

Alzheimer’s dementia tends to exhibit a higher prevalence and lifetime risk in women compared to men. Since old age is the most significant risk factor for Alzheimer’s disease, the relatively longer average lifespan of women may contribute to this epidemiological disparity. Recent studies have also reported a decline in dementia incidence among women due to increased educational and occupational opportunities. Additionally, there are notable sex differences, such as women being more susceptible to Alzheimer’s neuropathology and experiencing more severe clinical symptoms at the same pathological stage compared to men. The association between apolipoprotein E4, a risk gene for Alzheimer’s dementia, and disease incidence is also stronger in women than in men. Women’s relatively preserved language function further increases the likelihood of delayed diagnosis. The role of sex hormones is actively being investigated in the pathogenesis and treatment of Alzheimer’s disease. High parity, bilateral oophorectomy before menopause, and other factors are known to elevate the risk of Alzheimer’s dementia in women. Despite inconsistencies in the results of studies examining the relationship between exogenous hormone replacement therapy (HRT) and cognitive function, differences in the duration, type, and timing of HRT have been identified as contributing factors, necessitating further research.