Photo Credit: by Sofia Righi, Flickr.com
Have you ever thought of about why older women are more affected by dementia than men of their age? If yes, then this article brings answers to all of your questions!
Although, women of middle age are found to have better memory than middle aged men, as women go through the transition of menopause, there appears to a be significant decline of memory in women, according to research. Alzheimer’s disease and dementia are look-alike terms and can be confusing. In this article, we will get an overview of Alzheimer’s disease vs Dementia vs Memory loss. Factors contributing to Alzheimer’s disease in women, available treatment options and future perspectives for Alzheimer’s disease will also be discussed.
Dementia Vs Alzheimer’s Disease Vs Aging related memory loss
Dementia is a group of symptoms that commonly include problems with memory, thinking, problem solving, language and perception. Dementia is a diagnosis of a collection of symptoms, including memory loss. It is not a normal part of aging. Alzheimer's disease is a neurodegenerative disease that usually starts slowly and gradually worsens over time becoming severe enough to interfere with daily tasks; it is a type of dementia that causes problems with memory, thinking and behaviour. Alzheimer’s is the most prevalent type of dementia. According to the Alzheimer’s Association, it accounts for 60-80% of all types of dementia. Dementia is caused by different diseases that affect the brain. Apart from Alzheimer’s disease, there are other causes of dementia like Lewy body dementia, vascular dementia, frontotemporal dementia, Parkinson’s dementia, etc. Whereas, aging related memory loss is a usual phenomenon of the body with the increasing age, changes occur in all the parts of the body including the brain, which can make older people take longer to learn new things or forget where they’ve placed items, but eventually they remember.
Why does Alzheimer’s affect genders differently?
Alzheimer’s disease in women outnumbered men by a ratio of 2:1. Age is considered as a major factor for Alzheimer’s disease and women in general live longer than men. Even after taking into account the difference in longevity, some studies have suggested that women are still at a higher risk. Some other factors which can contribute to the risk of dementia includes air pollution as proved by USC researchers, less education in females are considered as one of the main cause of dementia, however with greater educational and occupational attainment in women, these gaps are being filling up. Depression and low exercise and fitness level along with APOE4 gene in women plays a significant role in developing Alzheimer’s disease in women more than men.
Women have better verbal memory skills than men, so women do usually perform better in the verbal memory test (initial diagnostic test for Alzheimer’s disease) which makes women underdiagnosed even if they are having cognitive impairment. That is the reason why dementia is diagnosed in women at a later stage and once diagnosed, women deteriorate faster than men.
Conversely, Petersen's study found that mild cognitive impairment was 1.5 times higher in men compared to women. "This is the first study conducted among community-dwelling persons to find a higher prevalence of mild cognitive impairment in men," Petersen says in a news release. "If these results are confirmed in other studies, it may suggest that factors related to gender play a role in the disease." For example, he says, "men may experience cognitive decline earlier in life but more gradually, whereas women may transition from normal memory directly to dementia at a later age but more quickly."
Why Women have better memory in middle age than men? How it is affected by menopause?
A new study proves that middle-aged women outperform age-matched men on all memory measures, although memory does decline as women enter post menopause. Professor Dr Jill Goldstein of Harvard Medical School said “Women report increased forgetfulness and ''brain fog'' during the menopausal transition. Given that women are disproportionately at risk for memory impairment and dementia in contrast to men, improving our understanding of sex differences in cognitive ageing is paramount.”
The study's aim was to investigate changes in memory function that occur in early midlife as a function of sex, sex steroid hormones, and reproductive status. It involved 212 men and women aged 45 to 55 and it assessed episodic memory, executive function, semantic processing, and estimated verbal intelligence through cognitive testing. Associative memory and episodic verbal memory were assessed using a Face-Name Associative Memory Exam and Selective Reminding Test. Professor Goldstein said: “In this population-based study, we identified specific changes in memory function that occur during early midlife as a function of sex and menopause status in women. “Women performed significantly better than age-matched men across all memory measures.” “This held true until post-menopause, when the memory performance advantage among women attenuated, in particular for the retrieval of previously recalled information.” “Declines in estradiol levels in postmenopausal women were specifically associated with lower rates of initial learning and retrieval of previously recalled information, while memory storage and consolidation were maintained.”
How can dementia in patients with Alzheimer’s disease be improved?
When it comes to the outcomes, quality of life, well-being are more humanistic outcomes that can be measured on a scale. In addition to the medications, recreational therapies like art therapy and music therapy approaches can really help enhance the personhood of the person living with dementia. People with memory loss can still continue to express thoughts, feelings and emotions in a healthy way. Art-making is a way to activate cognition and can also decrease the stress, agitation and isolation often associated with memory loss.
Music therapy is the use of music to help address physical, emotional, behavioural and social needs of an individual. For people living with dementia, music can allow for self-expression and engagement. Music therapy works by calming agitation, improving mood and increasing the person’s social interaction. Amygdala is the emotional part of the brain, which is unaffected by Alzheimer’s disease, music taps into amygdala and it can transport people with dementia to a previous time in their life via the memories that are connected to the music. The basic idea behind these recreational therapies is to maintain person’s engagement into social life. Aerobic exercises, fun play games, meditation, etc. releases endorphins from the brain which helps the patient to revive from the stigma of memory loss. Some food products like turmeric (curcumin), chocolate (flavonoids), blueberry, cinnamon (cinnamaldehyde and epicatechin), spinach, kale, fatty fish (omega 3 fatty acids), nuts like walnuts and almonds, champagne are found to have proven benefits in Alzheimer’s disease by protecting the brain from beta amyloid plaques.
What are the treatment options and future perspectives?
There are also pharmaceutical options available for treatment of Alzheimer’s disease. Cholinesterase inhibitors like Donepezil (Aricept), Memantine hydrochloride (Ebixa and Namenda), Rivastigmine (Exelon), and Galantamine (Razadyne ER and Reminyl) are approved for the treatment of mild, moderate and sever Alzheimer’s disease.
Apart from the conventional medications, authorities in China have approved a seaweed-based drug, called Oligomannate, for the treatment of Alzheimer's disease. The approval is conditional however, meaning that while it can go on sale during additional clinical trials, it will be strictly monitored and could be withdrawn should any safety issues arise. In a paper in the journal ‘Cell Research’, Geng's team described how a sugar contained within seaweed suppresses certain bacteria contained in the gut which can cause neural degeneration and inflammation of the brain, leading to Alzheimer's. This mechanism was confirmed during a clinical trial carried out by Green Valley, a Shanghai-based pharmaceutical company that will be bringing the new drug to market.
In recognition of November as National Alzheimer’s Disease Awareness Month, state Rep. Camille Y. Lilly is highlighting the importance of early detection for Alzheimer’s disease. Lilly is urging families to visit the Alzheimer’s Association’s website, alz.org in order to become familiar with the signs of Alzheimer’s and the differences between typical age-related changes and the specific warnings of Alzheimer’s and dementia.
To date, available medications can only reduce or control its symptoms. But Arizona-based medical device company, NeuroEM Therapeutics recently announced a new wearable device called MemorEM that works by disrupting the toxic proteins A-beta and Tau to reverse the cognitive impairment caused by Alzheimer’s disease. The study was published in Journal of Alzheimer's Disease, stating the device did not cause any negative effects on users. Participants showed enhanced cognitive performance after two months of treatment.
N&N Comfort Care Kits are also found to provide relaxation and sensory stimulation in the form of activities that will eliminate boredom and ultimately responsive behaviours for the person with dementia while away from home.
In conclusion, Dementia and Alzheimer’s disease are different on a varied level of symptomatology and treatments. Talk to your doctor if you’re concerned that you or any of your relatives have the symptoms of dementia or Alzheimer’s disease. Starting treatment promptly can help manage the symptoms.
###
Dr. Monika Yadav is a Physician, Clinical Microbiologist and Clinical Researcher. Monika loves coffee, music and visiting new places, and in her free time enjoys cooking, gardening and reading. She writes about interesting facts in the area of medicine and research in her spare time.
Your email address will not be published. Required fields are marked with *.