Gender Differences in Alzheimer’s Disease
Women are more likely to fear developing the condition as they age
By Neelum T. Aggarwal, MD
The relationship between gender and medical disease is a growing area of interest among clinicians and researchers alike. Data from many countries suggest that men die younger, while women bear a heavier burden of chronic illness. Studies also suggest that men and women behave very differently in their use of health care services. They have different thoughts and beliefs about disease, and perceive their risk of developing disease differently. This latter theme—gender differences in perceived risk—has also been examined by researchers in all disciplines using various modalities.
How the sexes perceive their risk of developing Alzheimer’s disease is one emerging area of interest. Studies have shown that women are indeed at greater risk of developing Alzheimer’s disease.
An Israeli study in 2012 documented these potential differences in a telephone survey of people age 18 and up. Assessing levels of concern about developing Alzheimer’s disease, researchers made 1,292 phone calls using random digit dialing. Of the 632 participants who gave complete interviews (67.5%), the majority were female (52.5%), with a mean age of 45 (age range of 18-88) and average education of 14 years (range of years 0-28). Most were married (70%) and a quarter (25%) reported having a relative with Alzheimer’s disease.
One question assessed awareness: “Did you ever hear about AD?” A negative answer was rated as 0 and a positive answer was 1. Questions about susceptibility, fear or worry about developing AD, were assessed with separate questions, and answers and were based on the Likert scale (1 = not at all likely to 5 = very likely). Socio-demographic variables included gender, age, education, marital status and ethnicity.
The study found that men and women had similar levels of awareness, but significant differences in mood-related symptoms, such as perceived susceptibility, worry, and fear of developing Alzheimer’s disease. Moderate to high overall perceived susceptibility was observed in 12% of men, compared to 18% of women. The number of women reporting these symptoms was consistently higher and the differences were statistically significant at p<0.001).
The predictors of belief and mood observed in this study tend to vary widely, except for perceived disease susceptibility. Higher perceived susceptibility was related to familiarity with someone who had Alzheimer’s disease, less education and higher age.
Susceptibility Key to Changing Behavior?
What do these findings potentially mean for education and awareness campaigns internationally and here in the United States? Tailoring Alzheimer’s disease education to focus on susceptibility could be more effective in changing behavior. Research in health behavior has shown that perceived “vulnerability” may influence behavior more than simple education.
Because of our increasingly diverse population, research in this area must include multiethnic communities to examine potential racial and ethnic differences in disease perception along with sex and gender differences.
Studies utilizing telephone interviews have already noted differences among multiethnic populations in their perceptions of Alzheimer’s disease. African-Americans and Hispanic respondents were more likely to believe that Alzheimer’s disease is a normal part of aging. However, more research is needed in these cohorts, on sex and gender along with race and ethnicity and their relationship to disease incidence. Such research will provide valuable information for clinician researchers in the field of aging and dementia, helping us to provide the best possible care in a culturally specific and sensitive manner, while also being aware of existing sex and gender differences.
For a list of references, please contact esidney@cmsdocs.org.
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