Women carry the greatest burden of Alzheimer’s disease, with higher rates than men worldwide, according to the Journal of Alzheimer’s Disease. For decades, scientists have searched for reasons to explain this difference.

While life expectancy may play a role, public health specialists believe other factors affect how Alzheimer’s disease develops in men and women.

This article highlights some of the key factors that may help explain gender differences in Alzheimer’s disease.

Is Alzheimer’s More Common in Men or Women?

Two-thirds of people in the U.S. living with Alzheimer’s disease are women — around 4.4 million out of the 7.2 million people over age 65 with Alzheimer’s disease. This makes the search for sex-specific risk factors one of the most critical areas of current research in the field.

According to Psychiatric Times, researchers used to believe this was because women live longer, and Alzheimer’s disease risk increases with age. However, new studies show women are still more likely to develop the disease even after adjusting for lifespan differences.

People with Alzheimer’s disease typically live between three and 10 years after their diagnosis, though this depends on age and overall health. Younger adults often live longer, while older adults may have a shorter survival time. The variability in survival time highlights the importance of early diagnosis and personalized care plans.

A Swedish study of 16,926 people (over the age of 65) found that women are more likely than men of the same age to develop Alzheimer’s disease. This finding reinforces the medical consensus that simply living longer does not fully explain why women are disproportionately affected.

Older age plays a role, but public health specialists still don’t fully understand why women face a higher risk for Alzheimer’s disease than men.

Why Is Alzheimer’s More Common in Women?

Research shows that Alzheimer’s disease may progress in men and women in unique ways. Alzheimer’s researchers are studying biology, hormones, and social factors to find out why. Exploring how these factors impact gender differences in Alzheimer’s disease helps us better understand how to treat and diagnose the disease.

The Brain

Brain scans show that women have more nerve-damaging proteins in their brains than men. These proteins, called amyloid beta plaques, build up in the brain over time and block communication between nerve cells. This makes it hard for the brain to work well.

Studies show that compared with women, men won’t start showing Alzheimer’s symptoms until there are more of these harmful proteins in their brains. With fewer proteins, women tend to show memory loss and other signs of disease earlier.

Estrogen and the Menopause Window

According to the journal Immunity, hormonal changes are different for males and females and affect how diseases develop. For women, menopause may influence Alzheimer’s risk because estrogen levels drop. Menopause is when menstrual periods stop and the body stops producing as much of the hormones estrogen and progesterone. Estrogen is a potent hormone that helps safeguard nerve cells against damage, and this protection drastically decreases during menopause. Menopause generally occurs between ages 45 and 55.

Estrogen helps cells communicate and lowers inflammation. When estrogen levels drop, the brain may have a greater risk for developing Alzheimer’s disease. The drop in estrogen during menopause may explain the increase in the brain’s vulnerability to Alzheimer’s over time and why some women notice memory and cognitive function problems in midlife.

Some studies show that people who have higher estrogen levels during their lives may be better protected against the disease, potentially delaying the onset of cognitive decline. These individuals may have had their first period earlier or started menopause later.

Genetic Differences

According to Alzheimer’s Society, genes help explain why Alzheimer’s disease is more common in women. Some genes work differently between the sexes.

One gene, called APOE4, is a risk factor for Alzheimer’s disease. This gene affects how well the brain clears harmful waste (amyloid beta plaques). When this gene doesn’t work properly, these proteins build up and the risk of developing Alzheimer’s disease increases.

Studies show that APOE4 may have a stronger effect in women. It is less effective at clearing these proteins in women, which could help explain why there are gender differences in Alzheimer’s disease.

Medical Conditions

According to Psychiatric Times, women are more likely than men to have depression and autoimmune disorders. These conditions make the immune system work harder, which can cause extra inflammation in the brain. Greater activity may lead to buildup of harmful proteins in the brain, damaging memory and thinking and increasing the risk of developing Alzheimer’s disease.

Education and Cognitive Reserve

According to Alzheimer’s Society, biology isn’t the only cause of Alzheimer’s — life experiences also influence how the disease affects men and women differently.

Education is important because learning keeps the brain active and strong. Brain activity builds cognitive reserve, which protects the brain and may delay the start of Alzheimer’s disease. Cognitive reserve is the brain’s ability to remain strong and keep working well. It helps people think, remember, and solve problems, even if the brain faces challenges.

In the past, women had fewer opportunities to get an education, which limited their chance to develop cognitive reserve. This may partially explain why they have a higher risk of developing Alzheimer’s disease.

Alzheimer’s research shows that when educational access improves, the dementia gap between men and women lessens. This is a hopeful finding, as it demonstrates that public policy and lifestyle changes focused on brain health can actively reduce dementia risk. This suggests that education impacts brain health.

Learning and Memory

The Women’s Brain Project found that women with Alzheimer’s disease often lose memory and language skills faster than men at the same stage. Brain scans show greater brain shrinkage in affected women.

According to the journal Neurology, women tend to have better language skills, so early symptoms may be harder to detect, which in turn leads to later diagnosis.

Caregiving, Stress, and Sleep

Women are more likely than men to be unpaid caregivers, which often causes long-term stress. Caring for someone with Alzheimer’s disease or dementia is especially difficult.

Women make up more than 60 percent of Alzheimer’s disease and dementia caregivers, and often feel more stress than men.

Long-term stress raises cortisol, which is the body’s primary stress response. Higher cortisol can harm sleep and immune responses, which may increase the risk of memory loss.

Deep, restful sleep is essential because it activates a system involved in clearing harmful proteins from the brain, known as the glymphatic system. Sleep may help prevent the development of Alzheimer’s disease. Getting enough sleep is important to lower stress.

Can Alzheimer’s Be Prevented or Solved?

There’s no cure for Alzheimer’s disease, but comprehensive lifestyle changes can lower risk and slow the disease:

• Stay active — Aim for moderate exercise weekly.
• Eat a balanced diet — Foods like fruits, vegetables, whole grains, fish, and olive oil help keep your brain healthy.
• Manage cardiovascular risk — Control blood pressure, cholesterol, and blood sugar.
• Challenge your mind — Keep your brain strong. Read, do puzzles, and participate in social activities.
• Quality sleep — Quality sleep may help clear amyloid beta plaques.

Join the Conversation

On myALZteam, people share their experiences with Alzheimer’s disease, get advice, and find support from others who understand.

Have you noticed differences in Alzheimer’s disease between men and women? Let others know in the comments below.