Women, Dementia, and Alzheimer’s Disease

Understanding your risks for brain disorders and how to improve your brain health. 

Demetrius Maraganore, MD, FAAN

Perhaps you grew up with an elderly aunt who everyone said was “dotty.” Or maybe you lost your grandmother to Alzheimer’s, or are currently dealing with your mother’s gradual slide into dementia. If so, it’s critical that you understand your own risks for Alzheimer’s disease and related brain disorders.  

“It’s not uncommon for us to recall a loved one with dementia,” notes Demetrius Maraganore, MD, FAAN, Co-Director of the Tulane Center for Clinical Neurosciences and Professor of Neurology. “And the million dollar question is what we can do to prevent it.” 

Dr. Maraganore’s Tulane clinical practice is in brain health and the evaluation and management of memory disorders, including Alzheimer’s disease. His passion is helping patients achieve successful brain aging by preventing cognitive decline and dementia in at-risk persons.   

Understanding Your Risks 

Data published by the Alzheimer’s Association estimates that at any age, women have twice the risk for developing the disease than men. The most startling fact is that from age 85, 1 in 5 women and 1 in 10 men will develop Alzheimer’s in their lifetime. And while not every study confirms these general differences, most show that women are more predisposed to the disease, even when taking life expectancies into account.  

These differences may be due in part to sex hormones, as estrogen and testosterone seem to protect the brain from age-related cell death. Comments Dr. Maraganore, “Men continue to produce sex hormones throughout their lives, but women stop producing them during menopause (usually occurring between ages 45 and 55), and so lose estrogen’s protective effects. The high risk is also found in women who have had their ovaries removed.” 

Genetics 

Every human being inherits one copy of every gene from their mother and one from their father. And of the thousands of genetic variations, Apolipoprotein (ApoE) is the major genetic determinate whether a person will develop dementia in their lifetime or not. In simplistic terms, if you inherit one copy of these key genetic variations, you have a 25% greater lifetime risk of developing Alzheimer’s. If you inherit two copies, the risk increases to 50% or greater.  

Within the general population (through our unique inherited genetic variations), the risk of developing the disease translates to 20% of people having moderate risk, 5% a high risk, and 75% having a low risk.  

Another Key Factor?  

Aging. Most cases of dementia and Alzheimer’s aren’t seen until age 65 or older, and “early onset dementia” (younger than age 65) is unusual. 

Improving Your Brain Health 

While scientists don’t yet have the ability to reengineer people’s genomes, one-third of Alzheimer’s cases are preventable. For them – and even for those two-thirds who are predisposed to risk of the disease – by modifying health risk factors, the odds of developing and delaying the onset of the disease can be reduced so that it doesn’t occur until after their death, or later in life. 

Among the related brain disorder risk factors that can be modified for better brain health are:  

  • Heart disease/hypertension 
  • Stroke
  • Diabetes
  • High cholesterol
  • Obesity
  • Depression
  • Smoking
  • Excessive alcohol consumption
  • Poor nutrition
  • Head injuries
  • Sleep deprivation
  • Physical inactivity 

More than anything, dementia is a complex trait. There is no one factor that is deterministic of risk; it might not be estrogen (or hormones) that create the higher risk in women. And then there are mitigating factors for developing dementia, including getting sufficient levels of Vitamin D, being physically active, getting adequate sleep, staying mentally engaged, playing a musical instrument, eating nutritious foods (and adhering to the Mediterranean diet in particular), and more. 

Good News 

On a good note, Dr. Maraganore explains, “research has shown that healthy habits earlier in life can positively impact brain health later in life,” and that’s why Tulane Neurology formed the Brain Health Program with two clinics.  

The program offers a range of assessments that provides a profile of an individual’s dementia risks. A team of specialists then works with each patient to modify those risks, and through a personalized medical approach, improve their brain health. Dr. Maraganore proudly notes that, “through 20 or more interventions, we can personalize an individual’s health needs and reduce their susceptibility for brain disease by 50-60%.” 

Patients can self-refer; a physician’s referral is not required. For more information, see TulaneNeuro.com.

Tulane Brain Health Program has two locations: 
Metairie at East Jefferson Hospital (504.503.7001) 
Covington at Lakeview Hospital (985.951.3222) 


Trevor Wisdom is the managing editor of Nola Boomers. 

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