Consideration of sex and gender in Alzheimer's disease and related disorders from a global perspective

Michelle M. Mielke*, Neelum T. Aggarwal, for the Diversity and Disparity Professional Interest Area Sex and Gender Special Interest Group, Clara Vila-Castelar, Puja Agarwal, Eider M. Arenaza-Urquijo, Benjamin Brett, Anna Brugulat-Serrat, Lyndsey E. DuBose, Willem S. Eikelboom, Jason Flatt, Nancy S. Foldi, Sanne Franzen, Paola Gilsanz, Wei Li, Alison J. McManus, Debora Melo van Lent, Sadaf Arefi Milani, C. Elizabeth Shaaban, Shana D. StitesErin Sundermann, Vidyani Suryadevara, Jean Francoise Trani, Arlener D. Turner, Jet M.J. Vonk, Yakeel T. Quiroz, Ganesh M. Babulal

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

46 Citations (Scopus)
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Abstract

Sex or gender differences in the risk of Alzheimer's disease and related dementias (ADRD) differ by world region, suggesting that there are potentially modifiable risk factors for intervention. However, few epidemiological or clinical ADRD studies examine sex differences; even fewer evaluate gender in the context of ADRD risk. The goals of this perspective are to: (1) provide definitions of gender, biologic sex, and sexual orientation. and the limitations of examining these as binary variables; (2) provide an overview of what is known with regard to sex and gender differences in the risk, prevention, and diagnosis of ADRD; and (3) discuss these sex and gender differences from a global, worldwide perspective. Identifying drivers of sex and gender differences in ADRD throughout the world is a first step in developing interventions unique to each geographical and sociocultural area to reduce these inequities and to ultimately reduce global ADRD risk. Highlights: The burden of dementia is unevenly distributed geographically and by sex and gender. Scientific advances in genetics and biomarkers challenge beliefs that sex is binary. Discrimination against women and sex and gender minority (SGM) populations contributes to cognitive decline. Sociocultural factors lead to gender inequities in Alzheimer's disease and related dementias (ADRD) worldwide.

Original languageEnglish
Pages (from-to)2707-2724
Number of pages18
JournalAlzheimer's and Dementia
Volume18
Issue number12
DOIs
Publication statusPublished - Dec 2022

Bibliographical note

ACKNOWLEDGMENTS:
This project was supported by grants from the National Institutes of Health/National Institute on Aging: RF1 AG55151 (MMM), U54 AG44170 (MMM), R01AG068183 (GMB), R01AG067428 (GMB), R01AG074302 (GMB), F32AG071273 (LED), T32AG000279 (LED), R01AG062637 (NTA), R01AG073627 (NTA), P30AG010161 (NTA), P30AG072975 (NTA), T32AG055381 (CES), R03 AG 67062 (DMVL), K23 AG073528 (BB), P30AG059301 (SAM), P30AG024832 (SAM), K23AG065442 (SDS), K99AG066934 (JMJV), R01 AG054671 (YTQ), and 5R01AG066823 (YTQ); National Institutes of Health/National Institute of General Medical Sciences: SC3GM122662 (NSF); National Institutes of Health/Office of the Director National Institute of Allergy and Infectious Diseases, and Eunice Kennedy Shriver National Institute of Child Health & Human Development Building Interdisciplinary Research Careers in Women's Health Program‐BIRCWH: K12HD052023 (SAM); National Institutes of Health/National Institute of Neurological Disorders and Stroke: L30NS113158 (BB); National Institutes of Health/Office of the Director: DP5OD019833 (YTQ); Alzheimer's Association: AARF 2019A005859 (CVC); AARG‐21‐852512 (PA); 2019‐AARGD‐644788 (PG); AARF‐17‐528934 (SDS); BrightFocus Foundation: A2021142S (GMB); Ludeman Family Center for Women's Health Research Early‐Career Faculty Research Development Award (LED); Massachusetts General Hospital ECOR (YTQ); Alzheimer Nederland Fellowship: WE.15‐2018‐05 (J.M.J.V); and NWO/ZonMw Veni: Grant project number 09150161810017 (J.M.J.V).

Publisher Copyright:
© 2022 The Authors. Alzheimer's & Dementia published by Wiley Periodicals LLC on behalf of Alzheimer's Association.

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