Why Include Women in Aging Studies

🧠 Why are women nearly twice as likely to develop #Alzheimer’s disease? A new article in Nature Medicine by science journalist Sofia Moutinho brings together leading researchers—including Roberta Diaz Brinton, Lisa Mosconi, Michelle Mielke, and Justina Avila-Rieger—to explore what we’re finally beginning to understand about sex differences in Alzheimer’s risk. 🔍 A few key insights that stood out from a scientific perspective: Hormonal Shifts & Brain Metabolism As estrogen declines during menopause, the brain loses access to its primary fuel—glucose. Research led by Brinton suggests that in response, female brains shift to metabolizing auxiliary fuels, including lipids found in white matter. This shift may contribute to white matter damage and increased AD vulnerability. Neuroimaging Evidence: Mosconi’s neuroimaging studies show that menopausal women (ages 40–65) have: ▪️ 22% lower brain glucose metabolism ▪️ 11% less white matter ▪️ 30% more β-amyloid plaques compared to age-matched men She notes that Alzheimer’s may begin as a disease of midlife, long before symptoms appear. Metabolic Health & Prevention Windows: Mielke’s and Brinton’s research highlight how postmenopausal metabolic risk factors—like hypertension and insulin resistance—may accelerate cognitive decline. Hormone therapy may help reduce this risk, but outcomes depend heavily on timing, duration, and individual biology. Reproductive History Matters A large Kaiser Permanente study found that women with shorter reproductive spans had 20–31% higher Alzheimer’s risk. Surgical menopause further elevated risk, while having three or more children was associated with lower risk—potentially tied to social support factors later in life. Sexism as a Risk Factor Avila-Rieger’s research revealed that women born in U.S. states with higher structural sexism experienced faster memory decline after age 65—especially Black women, highlighting the role of social determinants. 📉 Despite making up two-thirds of global dementia cases, women have been underrepresented in AD trials and research. That’s slowly beginning to change—but there's still much more work to do. As Mosconi puts it: 🧠 “Research on sex and gender differences in dementia has grown, but there’s still much to uncover ... and we owe women centuries of research.” 📄 Full article posted 👇 🔗 https://lnkd.in/da9p94XR #WomensHealthResearch #Alzheimers #Menopause #Neuroscience #ClinicalResearch #SexDifferences #MidlifeHealth #GSDHealthResearch #DementiaAwareness #DigitalHealth

We've known for years that women experience a midlife spike in psychosis that men don't. We just never bothered to find out why. Michigan State researchers are finally asking the question with a $3.7 million NIH study tracking 750 women through perimenopause. This is the FIRST study to examine daily hormonal fluctuations (both estradiol and progesterone) and their connection to mental health outcomes like psychosis and bipolar disorder. Previous research looked at age as the factor. This study is investigating whether it's actually the hormonal shifts themselves driving increased psychiatric risk. The implications are significant. Not every woman going through perimenopause will experience severe mental health challenges, but we haven't had the tools to identify who's most vulnerable. From a public health perspective, being able to predict and intervene could transform care for millions of women. Researchers reported overwhelming interest from women wanting to participate. Women who felt unheard. Women who wanted their experiences validated by science. This is exactly why this work matters. At Midi Health, we see this every day. Women who've been to multiple providers, tried countless approaches, and still don't have answers. The gap between what women experience and what medicine understands is still far too wide. Research like this doesn't just advance science. It validates lived experience and builds the evidence base we need to change how we approach women's midlife health ... not as an afterthought, but as the critical life stage it is.

🧐 Spoiler: When your data isn’t inclusive, your solutions won’t be either! In brain health, the cost of designing without women is already too high. Women are the majority of #Alzheimer patients, yet they remain the minority in the research designed to help them. It’s not just a gap. It’s a systemic failure. Last week at Google, with the Women's Brain Foundation, we explored what happens when you combine three powerful forces: 🔬 Deep scientific expertise 🤖 Generative AI 💡 And a commitment to #inclusiveresearch that reflects sex and gender differences 👉 We're not just trying to fix a gap in data, we're addressing a flaw in design. 🧠 In #brainhealth, and especially in conditions like Alzheimer’s, #MultipleSclerosis, #Depression and #Migraine, women are overrepresented in diagnosis, but underrepresented in the studies that shape #prevention, care, and #treatment. That’s not just a scientific oversight: it’s a design flaw that limits our ability to deliver better outcomes for everyone. 📖 With the Women's Brain Foundation, we’ve just published a new piece on this on Nature Magazine, building on years of work: https://lnkd.in/e3k6Smvk The message is clear: #inclusivescience is not optional, it’s overdue. What gives us hope is that we have the tools, the data, and the technology to do better! We just need the will, and the collaboration, to redesign the models we’ve inherited. 💚 That's why I am grateful to Persistent Systems and Santosh Dixit for opening space for this dialogue, to the active support of Janaina Poeta Frey and Gabriela Nohava (Birrer) at Google, and to the powerhouse team at Women's Brain Foundation: Dr Antonella Santuccione Chadha, Mariapaola Barbato, Dr. Beatriz C., Dr. Roberta Marongiu, PhD, Janita Nath, it’s a privilege to stand tall beside you. 🙏 🙌 If this mission speaks to you, as a #scientist, #funder, #pharma company, #policymaker or #citizen, and you'd like to contribute to the work we’re doing, please get in touch! Let’s redesign science. Together. #WomensBrainHealth #PrecisionMedicine #TechForGood #GenderEquity #AIforGood #AIforHealth #SystemsChange #WBF

The fact that women are nearly twice as likely as men to develop Alzheimer’s disease is a well-documented but still not fully understood phenomenon. Several hypotheses have been proposed, including: 1. Hormonal Influence (Estrogen and Menopause) • Estrogen has neuroprotective effects, helping to support brain plasticity and metabolism. • During menopause, estrogen levels drop significantly, which may accelerate brain aging and increase susceptibility to neurodegenerative diseases. • Some studies suggest that women with early menopause or who have had their ovaries removed before natural menopause are at even higher risk. 2. Genetic and Molecular Differences • The APOE4 allele, the strongest genetic risk factor for late-onset Alzheimer’s, seems to have a greater impact on women than on men. • Women with one or two copies of APOE4 have a much higher risk of developing Alzheimer’s compared to men with the same genotype. 3. Differences in Brain Structure and Function • Women typically have a longer lifespan, which increases the overall risk of developing Alzheimer’s. • Some neuroimaging studies suggest that women have a faster rate of brain metabolism decline in Alzheimer’s-affected regions compared to men. • Sex differences in microglial activation and neuroinflammation could play a role in disease progression. 4. Immune System and Inflammation • Women generally have a stronger immune response than men, which can be protective against infections but might also lead to increased inflammation, a key driver of Alzheimer’s disease. • Chronic inflammation, particularly related to aging, may contribute to neuronal damage. 5. Lifestyle and Sociocultural Factors • Historically, women have had lower education levels and different occupational exposure than men, which could influence cognitive resilience. • Differences in cardiovascular health risks (such as stroke and diabetes) and physical activity levels may contribute to the disparity. Ongoing Research and Future Directions Scientists are actively investigating these factors, including: • Clinical trials testing hormone replacement therapy (HRT) timing and its effects on Alzheimer’s risk. • Studies on sex-specific differences in tau and amyloid pathology. • Research into the impact of pregnancy history, metabolic changes, and mitochondrial function. Understanding why women are more susceptible to Alzheimer’s could lead to gender-specific prevention and treatment strategies. https://lnkd.in/g5GMq_Rm

I have seen less written about women’s health in neuroscience compared to other therapeutic areas. However, a few fresh studies have emerged recently: - A US study (Alzheimer’s & Dementia) identified sexism as a risk factor for memory decline among women: women born in the most sexist US states experienced faster memory decline equivalent to 9 years of cognitive aging difference. - Another paper (Biology of Sex differences) is the largest study to date (500 newborns) to explore sex differences in brain structures. The research confirmed that brain structure differences between male and female infants are present from birth. - A study from the Spain (Nature Communications) explores brain changes during pregnancy, concluding that pregnancy leads to a 4.9% reduction in gray matter volume in 94% of the brain, with partial recovery postpartum, primarily in regions tied to social cognition. - One more US study (Cell Reports) sugests that female and male microglia, the brain’s immune cells, respond differently to the enzyme inhibitor PLX3397, a common tool in microglial research. The findings highlight the necessity of sex-specific research in diseases like Alzheimer’s and Parkinson’s. Clearly, the sooner we start looking into women’s health in neuroscience, the faster we can get more efficient therapies. As a reminder, 2/3 of Alzheimer’s patients are women. Among Parkinson’s patients, around 40% are women and they are more likely to experience some of the clinical manifestations and complications of PD as well as side effects of their PD medication.

Alzheimer’s doesn’t affect women more just because they live longer. It’s rooted in biology, and in the gaps in how we study the brain. New research shows that women don’t just have a higher prevalence of Alzheimer’s. They: • Decline faster once diagnosed • Are diagnosed later, even when symptoms appear earlier • Show greater cognitive resilience during aging—until that resilience gives out • Often carry more tau tangles in the brain than men • Are assessed with tools that were never designed to reflect their cognitive patterns But what surprised me most: → In mouse studies, having a second X chromosome protected the brain, even in the absence of female hormones → During menopause, the female brain shifts from glucose to fat as its primary fuel → Most Alzheimer’s research still overlooks women, intersex, and gender-diverse populations—or fails to include them meaningfully This isn’t just about Alzheimer’s in women. It’s about designing science that finally reflects the full spectrum of human experience. 🧬The full article is powerful & worth reading: https://lnkd.in/eQRydhnF If you’re working at the intersection of women’s health, brain science, or research equity—let’s connect. #Alzheimers #BrainHealth #WomensHealth #Neuroscience #PrecisionMedicine #EquityInScience #PublicHealth

NEW! Latest commentary from Women’s Age Lab in Journal of the American Geriatrics Society (JAGS) focused on our timely report “Women at the Forefront of Aging in Canada”. There are health conditions that affect women uniquely, like menopause, disproportionately, like dementia, or differently like heart attacks. Further research is needed to identify conditions where sex, gender, and age differences exist to better inform clinical management. When we focus on older women we also learn about older men, improving health for all. Learn more: https://lnkd.in/edsMqUtq University of Toronto, Department of Family and Community Medicine University of Toronto Women's College Hospital Joyce M Li Haley Warren Razan Rawdat Surbhi Kalia

Sex disparity in physiology research: a call to action. Women are generally under-represented in studies on muscle health and disease. Only 4% of studies published in major exercise science journals in 2019 were women-only. But known biological sex differences in muscle and whole-body metabolism may impact: - Rates of muscle and strength loss with ageing - The nature of metabolic diseases like type 2 diabetes - Responses to exercise interventions to improve functional and metabolic health A better understanding of these factors could inform more targeted interventions to treat—and prevent—chronic disease.

Brain health is a women’s issue—and we’re underinvesting in it. Advocates took their case to the Hill yesterday with some ⭐️ power - this is a nice clip from ABC News with Mandy Moore and Lupita Nyongo. ► Nearly two-thirds of Americans living with Alzheimer’s are women. A woman’s lifetime risk at 65 is ~1 in 5, versus ~1 in 10 for men. ► Women also shoulder most of the care: >60% of Alzheimer’s and dementia caregivers are women, providing billions of hours of unpaid care each year. ► Biology matters. Menopause is linked with measurable brain changes on imaging (glucose metabolism, gray matter) and has been associated with elevated Alzheimer’s risk signals—an urgent research frontier. ► Research hasn’t kept pace. Females have been underrepresented in neuroscience and clinical trials, and when women are included, many studies still don’t analyze results by sex. ► Philanthropy and policy are starting to respond, but the space remains underfunded relative to the need—even as leaders call out the gender research gap. https://lnkd.in/efHTbhgt Society for Women's Health Research (SWHR), UsAgainstAlzheimer's,George Vradenburg, Meryl Comer, Kathryn Godburn Schubert

"Medical research has shortchanged women for decades. This is particularly true of older women, leaving physicians without critically important information about how to best manage their health. One example: Many drugs widely prescribed to older adults, including statins for high cholesterol, were studied mostly in men, with results extrapolated to women. “It’s assumed that women’s biology doesn’t matter and that women who are premenopausal and those who are postmenopausal respond similarly,” said Dr. Stephanie Faubion, director of the Mayo Clinic’s Center for Women’s Health. “This has got to stop: The FDA has to require that clinical trial data be reported by sex and age for us to tell if drugs work the same, better or not as well in women,” she added." #WomensHealth #Menopause #FDA #ClinicalTrials #WomenOfACertainAge https://lnkd.in/dWfQmrC2