Dementia – why the gender gap? And is it a preventable illness?

Here are a couple of things you might not have known about dementia (hint: one of them is good news!):

It disproportionally affects women – 2 out of 3 people with dementia are women, with women at almost double the risk of developing the condition than men. It is the number one cause of ill health, disability and death in women.

Recent research suggests there are 14 (yes 14!) modifiable risk factors that could account for nearly 50% of dementia cases. Most of them centre around mid-life (between the ages of 40 up to the early 60s), giving us a golden opportunity to make some changes at this time of life and drastically reduce the risk.

Finally, some good news about dementia! Let’s take a closer look..

What is dementia?

Dementia is a brain condition that can affect memory, thinking, mood and behaviour. It is NOT a normal part of ageing. It’s a broad term that covers a number of different conditions such as Alzheimer’s (the most common form of dementia), vascular dementia, Lewy body dementia and others. There is no known cure but there are treatments for many of the symptoms and support and interventions that can help – the earlier the better.

What are the symptoms?

This can depend a bit on the type of dementia, but the common ones are:

Gradual but progressive worsening in memory and thinking – difficulty recalling recent events, names, struggling to find the right words, plan or problem-solve
Difficulty performing usual tasks of daily living
Behaviour, mood or personality changes
Increasing apathy or withdrawal

What causes it?

This is an area of ongoing research, with scientists looking at abnormal proteins in the brain (in Alzheimer’s) and also the tiny mini-strokes that are the result of atherosclerosis, or hardening of the arteries, in the small blood vessels of the brain (vascular dementia). Genes may play a role but we don’t fully understand this yet.

Why are women at greater risk than men?

We don’t really know the answer to this either, although there is clearly something going on here! Theories include:

Women live longer than men on average, so have more exposure to risk factors plus more time to develop the disease
Globally, women tend to have less access to education early in life, one of the risk factors for developing dementia
Do hormones and menopause play a role? Maybe – we know that oestrogen protects the brain, and women who go through early menopause (before the age of 40) have a higher risk of developing dementia, unless they take hormone replacement therapy. But the jury is still out on the role of “normal” menopause and dementia risk.
Women may be less likely than men to receive targeted risk factor management for cardiovascular disease, which also reduces dementia risk.

Tell me more about these modifiable risk factors!

As mentioned in the introduction, a recent report published in the Lancet identified 14 modifiable risk factors which account for nearly 50% of dementia cases. Imagine if we could cut the number of dementia cases in half! The most important ones for women are mid-life obesity and physical inactivity. Others include:

Low education attainment in early life
Midlife hypertension (high blood pressure)
High LDL cholesterol
Depression
Smoking
Diabetes
Hearing loss
Traumatic brain injury
Excessive alcohol use
Social isolation & vision problems later in life
Air pollution

Top tips for cutting dementia risk (for both women and men!)

30-60 minutes of daily physical activity. It doesn’t have to be hitting the gym; walking, gardening even housework all count.
Aim for a healthy weight range
Get your hearing and vision checked
Eat a healthy diet and keep alcohol intake to safe levels
Quit smoking
Manage hypertension, diabetes and depression
Protect your head – wear cycling helmets, manage sport concussions, falls prevention
Good quality sleep (mind the caffeine and screens before bed!)
Keep socially active and engaged with family, friends and community

You can check out your risk now with this free online risk calculator from the University of NSW – click HERE.

What should I do if I’m worried about myself, or someone close to me?

Not all memory problems are dementia, so don’t be afraid to have a chat with your GP if you have concerns. Early intervention can make a difference. Your GP can also help identify your risk factors and work with you to make some healthy, sustainable lifestyle changes. Dementia Australia has some excellent free resources including a new BrainTrack app for anyone worried about their memory or cognition (it will detect changes over time) and we’ve even got a couple of book suggestions for you below.