How Alzheimer's Disease Affects Women Differently

Medically Reviewed By William C. Lloyd III, MD, FACS
Senior Caucasian woman looking out window in deep thought or concern

Alzheimer’s disease (AD) affects nearly twice as many women as men, and when it comes to Alzheimer’s and women, researchers believe the condition may manifest differently, too. Women might exhibit different Alzheimer’s symptoms than men do, and Alzheimer’s may be more difficult to detect in women in its early stages. As more of these differences come to light, doctors could look to subtler, gender-based clues to diagnosing Alzheimer’s.

How Alzheimer’s Symptoms Develop

The exact cause of Alzheimer’s disease remains unknown, though researchers believe the condition results from excessive quantities of two types of proteins that can clutter up brain tissue and damage communication between nerve cells. This abnormal growth of proteins eventually causes memory loss, difficulty solving everyday problems, and an impaired ability to judge spatial relationships, such as the distance between one car and another while driving. These types of dementia symptoms usually develop gradually and initially may look similar in both men and women.

How Alzheimer’s Symptoms Differ Between Women and Men

While memory loss and other early signs of Alzheimer’s disease might appear similar in both men and women, the sexes can exhibit different behavioral and affective, or emotion-based symptoms as the condition progresses. For example, men might display aggressive behavior more often than women with dementia do.

A woman’s AD symptoms, on the other hand, can include intense or inappropriate expressions of mood that might range from depression and sadness to extreme elation. In addition, a woman’s facial and body language might change to reflect these moods. A woman who had been a very animated person her whole life may become relatively expressionless, for example. Lastly, while the course of Alzheimer’s in a man might be slow and incremental, a woman may experience a rapid decline after diagnosis, because women often are not diagnosed as early in the course of the disease as men are.

Why Women Are Diagnosed With AD Later Than Men

The journey to an Alzheimer’s diagnosis often starts when a person (or family member) notices some sort of cognitive decline: memory problems, sudden inability to balance the checkbook, momentarily feeling lost when driving home from church, etc. Most doctors evaluate these types of issues by administering a simple series of cognitive function tests. These tests typically involve tasks like reciting a list of words to the patient and then having her repeat the words back five minutes later. People with mild cognitive impairment (MCI) or Alzheimer’s disease usually can’t remember all of the words.

However, those types of cognitive function evaluations may work against early diagnosis in women because women’s brains possess a gender advantage when it comes to something called “verbal memory.” This is the ability to remember lists of words and other items. As a result of this natural ability, women often can recite back lists of words even when their cognition is impaired, delaying an early Alzheimer’s diagnosis.

Developing Sex-Specific Diagnostic Criteria for Alzheimer’s Disease

As researchers continue to investigate why women experience Alzheimer’s at a far higher rate than men, they are looking into the role female hormones might play as a predictive factor for diagnosing AD. Some of the suggestions for developing sex-specific diagnostic criteria for Alzheimer’s include evaluating a woman’s:

  • Age at onset of menstruation and at natural menopause

  • History of hormone replacement therapy in menopause

  • History of oophorectomy (surgical removal of the ovaries)

  • Pregnancy history

Beyond the possible role hormones play in a woman’s Alzheimer’s risk, some researchers also recommend creating new cognitive function tests that compensate for women’s natural verbal memory advantage in order to improve early diagnosis rates.

Women exhibiting symptoms of memory decline or impaired cognitive function should see a doctor for an evaluation, especially if they have a family history of Alzheimer’s disease or another dementia. Early diagnosis can lead to earlier interventions for Alzheimer’s, and while no cure yet exists, receiving an accurate diagnosis can allow you to plan for future caregiving needs.

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  1. Pregnancy and Reproductive History May Impact Dementia Risk
    Plus, the Move to Re-Think the Impact of Hormone Therapy on Cognition.
    Alzheimer’s Association.
  2. Women and Alzheimer’s. Alzheimer’s Association.
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    BrightFocus Foundation.
  4. Alzheimer’s Disease Fact Sheet. National Institute on Aging.
  5. Mazure
    CM, Swenson J. Sex differences in Alzheimer’s and other dementias. Lancet Neurol.

Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2020 Dec 2
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