Women are disproportionately affected by dementia – by quite a staggering, and sometimes underappreciated, margin. Worldwide, women with dementia outnumber men two to one, and they are also twice as likely to care for a loved one with the disease.

Scientists are yet to fully understand the underlying causes of such a marked divide. It is widely accepted that historically women have been underrepresented in medical research programmes, at both the preclinical (animal) study stage and in drug development trials.

There are myriad reasons for this, many of which are driven by assumptions that results from males apply to females – i.e., that the differences don’t matter – or, conversely, that hormonal cycles of females decrease the power or validity of study results – i.e. the differences matter too much. It wasn’t until 2016 that the National Institutes of Health in the US mandated that all government-funded animal research must include female animal models, to ensure at the very least that women weren’t inadvertently prescribed drugs at the excessive dose required by a larger man. A welcome move, but undoubtedly, overdue.

The result is a major gap in our collective understanding about why women develop these diseases more often than men. Could hormones play a role? Is the difference in average weight and body mass index important? Is life expectancy important? The answer to all these questions is that we simply don’t yet truly know.

And yet, as with so many elements of the gender divide, the tide is turning. In recent years, a movement has grown around empowering women to take action and protect their brain health. Organisations such as the World Dementia Council, Alzheimer’s Disease International and the Global Initiative on Women’s Brain Health are bringing global attention to the importance of understanding the health of women’s brains.

Recognition is also growing that programmes that encourage women to make brain healthy lifestyle choices, not only impact their own risk of future neurodegenerative disease, but also promote healthy choices in those around them. So often the ‘Chief Medical Officer’ for their family, women who have children or partners can take a leading role in decisions that affect the health of those they live with. To take food shopping as a stereotyped but important example, a recent study by Pew Research found that, in those living in couples:

  • 80% of women with children usually prepare the meals, for those without children it is 75%
  • 80% of women with children are the primary grocery shopper, and for those without children it is 68%

Empowering women with knowledge about the relationship between nutrition and brain health could therefore have a broad and powerful effect.

So how do we protect our brain health and that of those around us?

The good news is there is so much we can do.

We now understand a great deal more about what impacts our brain health than we did even ten years ago. For example, it is widely known that the diseases that lead to dementia start in midlife.

The onset of these diseases is driven by many factors, some of which we cannot change, such as our family history and genetics, but many of which we can, such as our lifestyle.

In 2020, the Lancet Commission on Dementia Prevention, Intervention and Care, found that up to 40% of dementias could be preventable, by modifying lifestyle risk factors from the early years onwards.

If we eat, exercise and sleep well we can help keep our brains healthy and fuelled with oxygen and nutrients. No matter our age, we need to stimulate our brains by being with people and learning new skills. And it is crucial we manage stress to stay as calm as possible at home and work.

Maintaining good physical health – keeping blood pressure and BMI low – as well as being vigilant for hearing loss, air pollution and head injury are all part of the prevention plan.

And of course, there is bridging the knowledge gap. The more women who actively participate in brain health research, the more we will understand about neurodegenerative diseases in general, and their effect in women in particular.

This International Women’s Day, you can choose to join that effort by signing up to Join Dementia Research, a service that matches volunteers to appropriate research projects across the UK. It is a simple, but so very effective way, to keep all of us moving forward.

Anna Borthwick

Executive Lead, Brain Health Scotland