June 17, 2011

Warding Off Dementia: Male/Female Susceptibility

As part of my on-going series about warding off dementia, I recently discussed research that highlighted the importance of strong social networks for seniors' brain health. Later, I mentioned research that indicated older women develop and maintain those networks better than men.

In a comment to that latter post, Grant asked this pertinent question:
Any idea whether, as a result of these interaction differences, women suffer dementia less than men, or at least later?
Turns out that there isn't a clear answer to this question. Here's what my research shows:

  • Older men may be at a risk of developing mild cognitive impairment (MCI), often a precursor to Alzheimer's disease, earlier in life than older women.Scientists evaluated the cognitive health of nearly 2,000 dementia-free older people and found that 16% showed signs of MCI and that it was consistently higher in men than women across all age ranges. The authors of the report on this study in Neurology also advised going to the source of studies like this for in-depth explanations, warning that bloggers and journalists often try to simplify studies for their readers, sometimes at the expense of the facts. So here's a link to the source: http://www.neurology.org/content/75/10/889.abstract.
  •  The prevalence of dementia for people age 90 or older was 46% for women and 28% for men, according to a 2008 study. But the scientists cautioned that the level of education might have more to do with this difference than gender. Education was significantly associated with the prevalence of dementia in women but not in men. The odds of having dementia were 36% to 46% lower among women with higher education that among those with a high-school education or less. The study data also suggested that women who get dementia live longer with it than men do. (But, of course, that's true of women generally.) Source: http://www.neurology.org/content/71/5/337.short.
  • In a smaller study involving 227 persons with dementia, the incidence of dementia among those age 80 was 34.7% for white women, 35.3% for white men, 58.8% for African-American women and 53.0% for African-American men. Gender differences were not significant within the racial groups. Rates differed significantly based on educational attaintment but only among the whites. (The Alzheimer's Association estimates that older African-Americans are almost twice as likely as older whites to have Alzheimer's or other forms of dementia.) Source:http://www.ncbi.nlm.nih.gov/pubmed/14728627
  • In a study of 2,759 elderly (age 65 and older) in Dade County, Fla., the prevalence of cognitive impairment for African American men was 17.0% and women 16.7%; Cuban men 9.4% and women 11.4%, and white non-Hispanic men 9.0% and women 8.6%. Source: http://www.sciencedirect.com/science/article/pii/S1047279702004374.
This snapshot is just a sampling of recent studies. My own unscientific theory is that much of the gender and racial differences shown might well be based on differences in educational attainment, social interaction, mental and physical exercise, and general health. But remember the warning above: journalists and bloggers often tend to generalize with certainty, while the "science" is usually much more complicated... and often ambiguous. 


Grant said...

Thanks, John, for this follow-up to my question. Much appreciated.
When you used the word  “ambiguity” in today’s article, I realized that ambiguity has been a kind of hidden theme here.  There’ so much of it in the recent research and observations you’ve shared:
·         Gender and dementia
·         CoQ10: on, then off
·         Resveratrol: on, then off
·         Ramipril: on, then off
·         Isradipine: on, then off
·         Losartan: on… for now
·         Niacin: yes, then no
·         Salt: no, then maybe
·         Stem cell research: good news, bad news
·         Health care reform: nothing BUT ambiguity
·         Federal spending, seniors and youth: who’s REALLY getting screwed?
And I remembered how – in your profile – you wrote that you could deal better with adversity than with ambiguity. So, I guess I want to ask is: how are you doing?

Charles Macknee, MA said...

Hi John and Grant,

I just want to punctuate Grant's very astute observation here, and of course thank John for the information above.
Although I believe John originally expressed his preference for adversity over ambiguity with regard to Parkinson's, it certainly could apply to dementia as well, and when you read many case accounts of ADRD diagnoses you find that preference explicitly made time and time again.
Personally, I am not interested in knowing about ANY diagnosis for ANY disorder for which modern medicine has no effective response. And that certainly applies in regard to Alzheimer's disease and the related disorders that seem to be very rapidly increasing in number...

Along that line, I often wonder whether anyone in the research community, "scientific," "biomedical," or otherwise has ever entertained the thought of comparing the evolution of new types of cognitive disorders with Big Pharma's need to enrich its financial bottom line, both for its highly-paid executives and its many enthusiastic shareholders?

Somehow, I seriously doubt it... 

John Schappi said...

Hi Charles -- Yours is a well-timed comment. I've just come across a major new study on the effectiveness of things being touted as effective against Alzheimer's.  It's not encouraging.  I'll be reporting on it in my next blog posting.

John Schappi said...

Hi Grant - - Short answer is that after saying that last year was the best of my life, this year may be even better.  But, of course, not everything is getting better. I intend to post a mid-year report on where I'm at and coincidentally I have my regular checkup with my neurologist on July 5. So soon after that, I'll report back.  Thanks for asking, though.