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. Stites; Erin Sundermann; Vidyani Suryadevara; Jean Francoise Trani; Arlener D. Turner; Jet M.J. Vonk; Yakeel T. Quiroz; Ganesh M. Babulal

doi:10.1002/alz.12662

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

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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 language	English
Pages (from-to)	2707-2724
Number of pages	18
Journal	Alzheimer's and Dementia
Volume	18
Issue number	12
DOIs	https://doi.org/10.1002/alz.12662
Publication status	Published - 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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Mielke, M. M., Aggarwal, N. T., for the Diversity and Disparity Professional Interest Area Sex and Gender Special Interest Group, Vila-Castelar, C., Agarwal, P., Arenaza-Urquijo, E. M., Brett, B., Brugulat-Serrat, A., DuBose, L. E., Eikelboom, W. S., Flatt, J., Foldi, N. S., Franzen, S., Gilsanz, P., Li, W., McManus, A. J., van Lent, D. M., Milani, S. A., Shaaban, C. E., ... Babulal, G. M. (2022). Consideration of sex and gender in Alzheimer's disease and related disorders from a global perspective. Alzheimer's and Dementia, 18(12), 2707-2724. https://doi.org/10.1002/alz.12662

@article{e46cadf9a32c4e1f99e57150adad35c4,

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

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.",

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

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: {\textcopyright} 2022 The Authors. Alzheimer's & Dementia published by Wiley Periodicals LLC on behalf of Alzheimer's Association.",

year = "2022",

month = dec,

doi = "10.1002/alz.12662",

language = "English",

volume = "18",

pages = "2707--2724",

journal = "Alzheimer's and Dementia",

issn = "1552-5260",

publisher = "Elsevier Inc.",

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}

Mielke, MM, Aggarwal, NT, for the Diversity and Disparity Professional Interest Area Sex and Gender Special Interest Group, Vila-Castelar, C, Agarwal, P, Arenaza-Urquijo, EM, Brett, B, Brugulat-Serrat, A, DuBose, LE, Eikelboom, WS, Flatt, J, Foldi, NS, Franzen, S, Gilsanz, P, Li, W, McManus, AJ, van Lent, DM, Milani, SA, Shaaban, CE, Stites, SD, Sundermann, E, Suryadevara, V, Trani, JF, Turner, AD, Vonk, JMJ, Quiroz, YT & Babulal, GM 2022, 'Consideration of sex and gender in Alzheimer's disease and related disorders from a global perspective', Alzheimer's and Dementia, vol. 18, no. 12, pp. 2707-2724. https://doi.org/10.1002/alz.12662

Consideration of sex and gender in Alzheimer's disease and related disorders from a global perspective. / Mielke, Michelle M.; Aggarwal, Neelum T.; for the Diversity and Disparity Professional Interest Area Sex and Gender Special Interest Group et al.
In: Alzheimer's and Dementia, Vol. 18, No. 12, 12.2022, p. 2707-2724.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

T1 - Consideration of sex and gender in Alzheimer's disease and related disorders from a global perspective

AU - Mielke, Michelle M.

AU - Aggarwal, Neelum T.

AU - for the Diversity and Disparity Professional Interest Area Sex and Gender Special Interest Group

AU - Vila-Castelar, Clara

AU - Agarwal, Puja

AU - Arenaza-Urquijo, Eider M.

AU - Brett, Benjamin

AU - Brugulat-Serrat, Anna

AU - DuBose, Lyndsey E.

AU - Eikelboom, Willem S.

AU - Flatt, Jason

AU - Foldi, Nancy S.

AU - Franzen, Sanne

AU - Gilsanz, Paola

AU - Li, Wei

AU - McManus, Alison J.

AU - van Lent, Debora Melo

AU - Milani, Sadaf Arefi

AU - Shaaban, C. Elizabeth

AU - Stites, Shana D.

AU - Sundermann, Erin

AU - Suryadevara, Vidyani

AU - Trani, Jean Francoise

AU - Turner, Arlener D.

AU - Vonk, Jet M.J.

AU - Quiroz, Yakeel T.

AU - Babulal, Ganesh M.

N1 - 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.

PY - 2022/12

Y1 - 2022/12

N2 - 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.

AB - 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.

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U2 - 10.1002/alz.12662

DO - 10.1002/alz.12662

M3 - Article

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AN - SCOPUS:85129179800

SN - 1552-5260

VL - 18

SP - 2707

EP - 2724

JO - Alzheimer's and Dementia

JF - Alzheimer's and Dementia

IS - 12

ER -

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

Abstract

Bibliographical note

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