"Women are both disproportionately affected by Alzheimer's Disease while also bearing the bulk of the caregiving burden," concludes Wiesje van der Flier, Scientific Director of the Alzheimer Center Amsterdam at Amsterdam UMC. Writing today, on International Women's Day as part of The Economist's Impact report on Sex, Gender and the Brain. For van der Flier, more research is necessary. Not only about how the disease develops biologically in males and females, but also how the gender of caregiving determines the care provided

Research from Amsterdam UMC has demonstrated that women likely have better cognitive reserves than men. When researchers looked at the presence of protein buildups associated with Alzheimer’s Disease, they found that women performed better despite already having more damage.  

Nevertheless, the majority of the 55 million people living with Alzheimer's Disease (AD), worldwide, are women. In the United States, this majority is as large as 66%. However, little is known about the reasons behind this inequality, and it is often presumed that it is mainly caused by the fact that women live longer, but in reality, difference in longevity does not explain the difference.  

"Fortunately, interest is developing in sex and gender differences. For us, the most important starting point is that Alzheimer's is more common in females than males. We’re not entirely sure why that is, but for other dementias, particularly Dementia with Lewy Bodies, it is the opposite. Sex and gender inclusive research is therefore very relevant,” says van der Flier.  

Diagnosis is Key 

Of the 55 million living with Alzheimer's Disease, 75% are undiagnosed. Without a diagnosis, those with Alzheimer's as well as those caring for those with Alzheimer's are often excluded from many resources that can offer help and support. Including formal support, such as day care, or mental support in the form of peer support or information about the disease and the changes it can cause.  

Last month, Amsterdam UMC, together with nine organisations in the Netherlands launched the project TAP-dementia. A research project that will search to improve these diagnostic rates and guarantee a Timely, Accurate and Personalised diagnosis for everyone with dementia. With the goal of providing appropriate care and treatment to those with dementia. 

Double Punishment

As well as suffering for the majority of cases of Alzheimer's Disease, women also account for almost 60% of caregivers. This means that women are not only more likely to develop Alzheimer's, but they are also more likely to have their life altered by providing care for a family member.  

For van der Flier, a diagnosis here is essential as it provides, most importantly, access to treatment, “In the end it is about treatment and for Alzheimer's, current treatment is mostly organising care, and there are clearly great gender issues involved as appropriate care is different for men and women.’’ 

Economic Impact 

As part of The Economist's Impact report, the economic effects of Alzheimer's Disease were also measured. There the authors noted that “Alzheimer's imposes the greatest burden of all brain disorders, with total healthcare costs from treatment alone standing at $305bn in the US”. In the US, it is estimated that 15 million people provide informal care to those with Alzheimer's and other dementias. This economic impact is something that in the future may be eased by treatment. Something than van der Flier believes makes more research even more relevant: “Now that we are approaching an era where disease modifying treatment becomes a reality, more than ever it is of relevance to diagnose and predict the disease and to find which treatment strategies, both pharmacological and non-pharmacological, work for whom, taking into account potential differences between men and women in all those aspects.” 

Read the full report from The Economist for the Women's Brain Project here.