Alzheimer’s: A Woman’s Disease Amanda G. Smith, MD Medical Director, USF Health Byrd Alzheimer’s Institute

Disclosures

▶  Grant/Research support: –  Lilly, Merck, Eisai, Cognate Nutritionals, TauRX –  Contract payment to site (not investigator)

Dementia ▶  Dementia is the loss of cognitive function with

aging due to degeneration of the brain ▶  Alzheimer’s is the most common form ▶  Definite diagnosis used to require autopsy ▶  Many mixed cases ▶  Some memory disorders are reversible and not

truly dementia

Alzheimer’s Disease ▶  The most common cause of dementia ▶  Affects 1 in 40 Floridians, 1 in 66 Americans ▶  1 in 3 seniors dies with some type of dementia ▶  Affects 10% of people over 65; 30-50% of

people over 85 ▶  Over 5.4 million Americans presently ▶  By 2050, predicted to affect 16-20 million ▶  6th leading cause of death in the USA ▶  Costs the nation $226 Billion annually ▶  By 2050 predicted to cost $1.1 Trillion

Women with Alzheimer’s

▶  Almost 2/3 of American seniors living with AD are women

▶  3.2 million women over 65 in the US ▶  16 % of women over 71 have dementia vs 11%

of men ▶  At age 65, a woman without AD has a 1 in 6

chance of developing it, vs 1 in 11 in men ▶  Women in their 60’s are 2x as likely to develop

AD than breast cancer over the rest of their lives

17.2  

9.3  

REMAINING  LIFETIME  RISK  OF  DEVELOPING  DISEASE  FOR  WOMEN  IN  THEIR  60'S:  

Risk  of  Alzheimer's   Risk  of  Breast  Cancer  

Why do women have higher risk?

▶  Women live longer ▶  Women are more likely to get AD if they carry

the ApoE4 gene than men are ▶  Differences in cardiovascular risk ▶  Estrogen effects ▶  Educational attainment, esp. in oldest old

Women as Caregivers for AD

▶  63% of unpaid caregivers are women ▶  60-70% of all caregivers are women ▶  Currently about 10 million women providing

unpaid care ▶  Women account for greater hours and greater

length of care than men

Women as Caregivers, continued

▶  Women are 2.5x more likely to provide 24hr care ▶  Women are 2.3 more likely to provide care for 5

years or more ▶  Women are more likely to help with personal

care ▶  Women are less likely to have additional support

from family and friends

Caregiving: effects on health

▶  ½ of female caregivers report physical stress compared to ¼ of male caregivers

▶  Nearly 2/3 of female caregivers report emotional stress

▶  1/3 of both men and women feel isolated but it is more commonly linked to depression in women

▶  ¾ of women express concern about their ability to maintain their health

20  

3  

PERCENTAGE  OF  WORKING  CAREGIVERS  WHO  HAVE  GONE  FROM  FT  TO  PT  WORK  

Women   Men  

Caregiving: Effects in the workplace

Caregiving: Effects in the workplace

▶  20% of women vs 3% of men have gone from full time to part time work due to caregiving

▶  19% of WWC had to quit working either to start caregiving or because it became too burdensome

▶  18% of WWC have taken a leave of absence from work

▶  10% have lost job benefits ▶  17% report feeling penalized by their employers

What can you do?

▶  Physical exercise ▶  Mediterranean type diet ▶  Wear helmets and seatbelts ▶  Control cardiovascular risk factors ▶  Research hormone replacement with your doctor ▶  Reduce stress when possible ▶  Join the movement at Mybrain.alz.org ▶  Join the Brain Health Registry at

brainhealthregistry.org