Two out three people with Alzheimer disease are women. Why are they at higher risk for this devastating condition than men? Even more important, how can they reduce their risk for dementia?
Many of the usual explanations for this imbalance don’t stand up well to scrutiny. Too many of them have been accepted without much evidence, such as the idea that women’s preponderance among people with dementia is a simple reflection of their greater longevity. While women do tend live a bit longer than men, the difference is not enough to explain the imbalance. Moreover, Alzheimer disease develops over decades, so scientists should be looking much earlier in life for the factors increasing the risk for dementia.
Another myth that many women accept is that genes are destiny. In other words, if your mother or grandmother had Alzheimer disease, then you are doomed to suffer from it yourself. That is simply not true, according to Dr. Lisa Mosconi. However, women who have a genetic predisposition may have to work harder to reduce their risk for dementia.
There are a number of factors to consider. Do you regularly use an anticholinergic medication? Such medicines can contribute to your risk for dementia, especially when taken over a long period of time.
Keep in mind that women’s brains react differently to certain medicines than men’s brains. One good example is the sleeping pill zolpidem (Ambien). Several years ago, the FDA established that a lower dose of this popular medicine is more appropriate for most women. It works as well and is less likely to cause side effects such as next-day hangover or sleep-driving.
Another factor to consider is menopause. When the body’s production of estrogen drops precipitously, many women experience effects such as hot flashes and night sweats. Starting estradiol therapy at the start of menopause may help cushion the brain from some long-term effects of going without it. It may also help protect a woman from the sleep deprivation so common during menopause.
Regular exercise is recognized as a pillar of health. But what kind of exercise is best for women? Research indicates that frequent bouts of low to moderate intensity exercise–such as walking or dancing–can be very helpful for women.
When it comes to diet, think Mediterranean to reduce your risk for dementia. We don’t mean pasta and gelato, though. A protective Mediterranean-style eating pattern includes plenty of vegetables and fruit, lots of legumes and nuts and very little meat and processed food (including desserts). Instead of meat, think about fish, eggs or even peanuts. All of these are good sources of choline, which is critical for maintaining brain health.
Lisa Mosconi, PhD, is the director of the Women's Brain Initiative and associate director of the Alzheimer's Prevention Clinic at Weill Cornell Medical College, where she serves as an associate professor of neuroscience in neurology and radiology. In addition, she is an adjunct faculty member at the NYU Department of Psychiatry. She is the author of Brain Food and The New York Times bestseller, The XX Brain.
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