The differences in cognitive impairment and dementia risks for men and women are intriguing, yet science has not revealed precisely why they exist.
Many studies have found little difference in the distribution of women or men who develop some form of dementia at any age. Dementia, particularly Alzheimer’s disease, appears to be more prevalent among women, likely due to greater life expectancy and better health later in life for women.
But evidence suggests men face a greater risk of the earliest signs of the disease. Mild cognitive impairment (MCI) at younger ages appears to be more common in men, even for those who do not go on to develop full dementia.
It is interesting that while men and women develop cognitive impairment at similar rates in many studies, the men and women who developed it differed in terms of risk factors.
Cognitive Impairment Risk Factors for Men
Identifiable risk factors for dementia in men fall into two somewhat overlapping categories: the development of heart disease before middle-age, and poor health habits, such as use of tobacco and immoderate alcohol use.
In general, any habit or dietary behavior that could lead to overall health decline increases significant risk factors for mental/cognitive impairment. Males with diabetes (types I and II) and stroke victims are known to be at greater risk of cognitive impairment. In fact, stroke victims are three times as likely to develop dementia.
Lifetime history of stroke was associated with a 70% increase in dementia risk, and recent stroke with a 50% risk increase. The association between stroke and dementia development was somewhat higher in men than women. As men are at greater risk of stroke than women, this is central to assessing concomitant sex risks of MCI and dementia.
Scientific Background on Sex as a Risk Factor
Differences in incidence rates by clinical subtype and by sex suggest that risk factors for MCI should be investigated separately for amnestic mild cognitive impairment (aMCI) and non-amnestic mild cognitive impairment (naMCI), as well as men and women.
From a 2012 Mayo Clinic study of a population from Olmstead County, Minnesota, as cited by Neurology.org:
“Among 1,450 subjects who were cognitively normal at baseline, 296 developed MCI. The age- and sex-standardized incidence rate of MCI was 63.6 (per 1,000 person-years) overall, and was higher in men (72.4) than women (57.3) and for aMCI (37.7) than naMCI (14.7). The incidence rate of amnestic aMCI was higher for men (43.9) than women (33.3), and for subjects with ≤12 years of education (42.6) than higher education (32.5). The risk of naMCI was also higher for men (20.0) than women (10.9) and for subjects with ≤12 years of education (20.3) than higher education (10.2).”
Having a specific form of a gene known as APOE-e4, which has been linked to Alzheimer’s disease, may also indicate risk. The presence of this gene, however, doesn’t always result in cognitive decline.
Addressing the Risk Factors for Dementia in Men
Men should take these risks seriously and discuss cognitive health with their physicians when developing ongoing health plans. June is Alzheimer’s and Brain Awareness Month, and this week is Men’s Health Week, providing a good opportunity for physicians to discuss these risks.
If your male patients notice, or others close to them notice, symptoms related to their mental performance, this could suggest early mild cognitive impairment (MCI). Some examples could include:
- Forgetting things more often
- Forgetting important events, such as appointments or social engagements
- Losing train of thought or the thread of conversations, books or movies
- Feeling increasingly overwhelmed by making decisions, planning steps to accomplish a task or understanding instructions
- Having trouble finding the way around familiar environments
- Becoming more impulsive or showing increasingly poor judgment
Helping Prevent Cognitive Impairment
While there are no guaranteed cures or therapies for age-related cognitive impairment, improving overall health can mitigate related risk factors:
- Maintain good relationships
- Manage and overcome depression
- Continued mental activity/high engagement
- Keep a healthy weight
- Prevent/treat diabetes
- Track mental health
- Fight risk of a stroke
Tracking Cognitive Health with BrainCheck
Exercise (or the lack thereof) is frequently mentioned as a risk factor for stroke and mental and cognitive losses. Tracking fitness with apps and technology has become commonplace — and helping patients track their cognitive health can, too.
With BrainCheck, you can assess and track your patients’ cognitive function over time, providing the patient with important insight into their brain health. And with this perspective, practices can help men and women alike address cognitive concerns earlier and more effectively.