Why are women far more likely to have Alzheimer's?

Estrogen, genes could play a role

Researchers are increasingly trying to determine what might explain why women are more frequently diagnosed with Alzheimer's disease than men, Lauran Neergaard writes for the Associated Press.

According to the Alzheimer's Association, women at age 65 have a one in six chance of developing the disease throughout their lifetimes, compared to men's one in 11 chance. Currently, about 66% of Americans with Alzheimer's disease are women.

Researchers have long attributed the discrepancy to women's longer life spans, but some scientists are now focusing on whether biological factors may also be to blame.

The states where the Alzheimer's population is surging

"It is true that age is the greatest risk factor for developing Alzheimer's disease," says University of Southern California Professor Roberta Brinton. But, "on average, women live four or five years longer than men, and we know that Alzheimer's is a disease that starts 20 years before the diagnosis," she adds.

Gene split

Scientists say genes play a role in whether men and women develop the disease—but that the effect on one gene tied to Alzheimer's has a much bigger effect on women. A Stanford University study of more than 8,000 people found that women who carried the form of a gene named ApoE-4 were about two times more likely to develop Alzheimer's than other women—while the gap between men with and without the gene was much smaller.

Brinton says the way estrogen interacts with the gene could play a role, leading women who carry the gene to experience decreased brain function.

Although there are several theories, many scientists are still at a loss to explain the disease's gender gap.

"There is a lot that is not understood and not known" about the disease, says Alzheimer's Association Chief Science Officer Maria Carrillo, adding, "There are enough biological questions pointing to increased risk in women that we need to delve into that and find out why."

The association intends to fund research to address some of those questions, Carrillo says (Neergaard, AP/UT-San Diego, 6/28).

The takeaway: Scientists are trying to determine why women are more prone to developing Alzheimer's then men—and some say it has to do with how estrogen and a particular genetic marker interact.

Here's how we can help…

For more information about how the aging population will affect hospitals and how hospital planners can improve geriatric services, check out some of our other research. 

Geriatric Services Strategy

By 2030, one in five Americans will be 65 years of age or older, representing a dramatic shift of patient mix toward high acuity, multi-morbid Medicare patients. To improve care and finances for treating this burgeoning population, hospitals may develop geriatric-specific programs. This webconference outlines key considerations for developing services specific to this growing and complex population.

Designing Geriatric Emergency Departments

Prompted by the aging Baby Boomers, providers have begun to reconsider how they provide emergency care to seniors. This report surveys the efforts of four hospitals and health systems to meet this challenge by setting up specialized geriatric emergency departments.

What is an outpatient geriatric assessment center?

Every day, 11,000 seniors become eligible for Medicare. How can health systems prepare to support this growing population’s future needs? To help seniors manage functional decline and proactively plan for future care, some organizations have implemented outpatient geriatric assessment centers, which offer comprehensive, multidisciplinary evaluations and treatment plans for complex, elderly patients. 

Strategies to Improve the Continuum of Care for Geriatric Patients

Administrators of geriatric care coordination and discharge planning programs report that constant and complete communication among providers is crucial to the success of their departments. Medication reconciliation presents significant challenges at some institutions, while others have adopted pathways and technology to facilitate the transmission of information across care locations. 

Furthermore, program managers note the importance of communication within the hospital to ensure that geriatrics services receive the support of top-level administrators at the institution.

Managing Dementia Patients Across the Care Continuum

As health care providers respond to federal incentives to develop care continuum models, no care alignment strategy between hospitals and post-acute care providers is complete without considering the dementia patient population.

Dementia patients pose significant challenges for providers—from treatment refusal to physically threatening behavior— and these challenges contribute to the higher admission rates and longer lengths of stay.


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