Cómo los roles de género influyen en la enfermedad de Alzheimer y por qué hay que investigarlo – Blog
Women and men could develop Alzheimer’s through different mechanisms. Understanding these differences is essential to treating the disease effectively.
[Este artículo ha sido publicado originalmente por Science Media Centre España.]
Alzheimer’s disease is a disease crossed by gender inequalities. Women make up the majority of those with the disease and, at the same time, they are the majority of caregivers for these people. Since age is the main risk factor, we might think that greater longevity in women could explain the greater number of cases. However, the reality is much more complex: men and women face different risk exposures, brain pathologies, and levels of resilience against Alzheimer’s.
This neurodegenerative disease is, in the vast majority of cases, a condition caused by a combination of genetic and environmental factors. This means that there is no single determining factor that explains the development of the disease. At a biological level, it is characterized by the deposition of amyloid and tau proteins, inside and outside neuronsrespectively. Neurons are brain cells that act as «messengers», receiving, processing and transmitting information to other neurons. In this way, they form a network that supports mental abilities, such as memory. Amyloid and tau pathologies make the work of these networks difficult, thus causing the symptoms of the disease: a progressive decline in mental abilities, and, finally, dementia.
Alzheimer’s disease is a disease marked by gender inequalities: women constitute the majority of those with the disease and, at the same time, they are the majority of caregivers of these people.
Currently, we understand that Up to two decades may pass from the onset of biological changes. in the brain until problems with mental abilities, known as symptoms, appear. During this long period, there are opportunities to influence the progression of the disease. Previous studies have investigated how to slow the buildup of amyloid and tau proteins to increase resistance to pathology. Alternatively, other studies have focused on understanding how to strengthen the ability of neurons to adapt to the accumulation of pathological proteins and maintain its function, which is known as disease resilience.
Resilience against the development of dementia
What can help increase resistance and resilience against the development of diseases such as dementia? Hay 12 risk factors recognized that increase the probability of developing dementia and that could explain up to 40% of cases. Among these factors are the education levelthe physical activity and the depression depressioninter alia. Improving these aspects can significantly influence the development of the disease, offering greater protection and the brain’s ability to adapt. But, What is the role of sex and gender in resilience to disease? The prevalence of protective and risk factors, the burden of Alzheimer’s pathologies, differ according to sex and gender, referring to biological factors versus socially constructed factors.
he sex refers to a person’s complement of sex chromosomes (XX vs. XY, female vs. male), which is reflected in the reproductive organs. In contrast, the gender It is a social construct that refers to socially constructed roles, identities, and behaviors. Gender is complex and changing, being influenced by both past and current social and cultural contexts. This binary approach (feminine/masculine, man/woman) has limitations, but it is the approach mostly used in research to date.
What do studies show about the role sex and gender play in resilience? A sex and gender perspective on Alzheimer’s disease implies understanding that female sex may be associated with greater protein accumulationat the same time as Historical patterns of gender inequality may help explain the higher risk of Alzheimer’s in women.
A sex and gender perspective implies understanding that the female sex may be associated with greater protein accumulation, while patterns of gender inequality may contribute to explaining the greater risk of Alzheimer’s in women.
Women initially cope better with the pathology. and the loss of neurons or neuronal connections, maintaining your mental abilities. Women thus show greater resilience to the first changes of the disease. For example, the greater initial resilience in women could be partially explained by the female sex, since research with animals (in which sex chromosomes can be manipulated in the laboratory) shows a protective role of the X chromosome in Alzheimer’s. However, women’s mental abilities decline faster than men’s as the disease progresses..
Thus, the initial resilience in women tends to fade as their mental abilities begin to deteriorate, leading to a diagnosis of Alzheimer’s disease. Here, biological sex also seems to play an important role since during menopause (associated with the female sex) there is a greater accumulation of the tau protein in the brain and there is a greater presence of other brain pathologies (such as vascular ones), thus contributing to greater neuronal damage.
Assessing how sex and gender interact is crucial
It is important not to lose sight of how Gender roles may influence disease risk. Some conditions that increase risk are more common in women, including low levels of education, physical inactivity, and affective disorders (inevitably linked to caregiving).
In an article published in Alzheimer’s and Dementia: The Journal of the Alzheimer’s Association, a group of researchers have highlighted the urgency of incorporating a sex and gender approach in studies on the pathology.
In fact, different investigations indicate that, in countries with lower gender inequalities, differences in mental abilities between men and women are decreasing. Women have been less encouraged to exercise and study, leading to a higher prevalence of physical inactivity among them and a lower level of education, compared to men. Previous studies have shown that the physical activity It is related to less accumulation of amyloid proteins in the brain. Furthermore, people with a highest educational levelAs well as those that carry out mental activities, they usually have a greater volume of neurons. in advanced ages. On the other hand, the depression depression and the stress could have a negative effect, reducing the number of neurons and potentially accelerating the accumulation of harmful proteins.
Evaluating how sex and gender interact is crucial to understanding the mechanisms that preserve mental abilities and reduce the accumulation of pathologies during aging and thus prevent Alzheimer’s disease. Sex and gender are intertwined with other socially constructed concepts, such as “race” and ethnicity, which are essential to understanding and addressing inequalities in disease development.
In the article published in Alzheimer’s and Dementia: The Alzheimer’s Association MagazineA group of expert international researchers have highlighted the urgency of incorporating a sex and gender approach in studies on Alzheimer’s disease. If women and men develop Alzheimer’s disease through different mechanisms, knowing these mechanisms is essential to design specific interventions and treat the disease effectively.
