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Clinical epidemiology of Alzheimer’s disease: assessing sex and gender differences

Authors Mielke M, Vemuri P, Rocca W

Received 1 October 2013

Accepted for publication 20 November 2013

Published 8 January 2014 Volume 2014:6 Pages 37—48

DOI https://doi.org/10.2147/CLEP.S37929

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 4


Michelle M Mielke,1,2 Prashanthi Vemuri,3 Walter A Rocca1,2

1Department of Health Sciences Research, 2Department of Neurology, 3Department of Radiology, Mayo Clinic, Rochester, MN, USA

Abstract: With the aging of the population, the burden of Alzheimer's disease (AD) is rapidly expanding. More than 5 million people in the US alone are affected with AD and this number is expected to triple by 2050. While men may have a higher risk of mild cognitive impairment (MCI), an intermediate stage between normal aging and dementia, women are disproportionally affected with AD. One explanation is that men may die of competing causes of death earlier in life, so that only the most resilient men may survive to older ages. However, many other factors should also be considered to explain the sex differences. In this review, we discuss the differences observed in men versus women in the incidence and prevalence of MCI and AD, in the structure and function of the brain, and in the sex-specific and gender-specific risk and protective factors for AD. In medical research, sex refers to biological differences such as chromosomal differences (eg, XX versus XY chromosomes), gonadal differences, or hormonal differences. In contrast, gender refers to psychosocial and cultural differences between men and women (eg, access to education and occupation). Both factors play an important role in the development and progression of diseases, including AD. Understanding both sex- and gender-specific risk and protective factors for AD is critical for developing individualized interventions for the prevention and treatment of AD.

Keywords: Alzheimer’s disease, dementia, sex, gender, risk factors, dimorphic medicine

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