While there’s no need to be alarmist about slightly worsening memory, which can be a sign of stress or lack of sleep as much as aging for many people, new research should ring alarm bells: women over age 60 with mild cognitive impairment decline twice as fast than men, according to a report from the Alzheimer’s Association International Conference (AAIC).

What’s more, the report states, nearly two-thirds of American seniors who have Alzheimer’s disease are women, and women age 65 without Alzheimer’s have more than a one in six chance of developing the disease or related dementia during the remainder of their lives, compared with only a 1 in 11 chance for men. Among those aged 71 and older, 16% of women have Alzheimer’s and other dementias, while only 11% of men do.

This data is forcing big questions in the Alzheimer’s research community. Why are women so vulnerable, and what can be done about it?

According to Dr Dean Hartley, director of science initiatives at the Alzheimer’s Association, age is the biggest risk factor for Alzheimer’s. “Since women live longer than men, what underlying biological changes for aging are there that we don’t know very well?” he asks. Several lines of research are looking into the difference of genetic expression in male and female chromosomes, which hasn’t been well studied in connection to Alzheimer’s, and of course, to sex hormones as a possible cause. “Estrogen may have something to do with the deterioration, as may menopause.”

Unfortunately these are only guesses right now. Hartley says that more funding is necessary to be able to do the clinical trials, continue research on drugs and expand diagnostic techniques.

Power of diagnostics

While there is no cure for Alzheimer’s (existing medications merely heighten the function of remaining synaptic connections), MRI imaging and PET scan diagnostics of the invasive amyloid and tau proteins respectively, may soon determine how early these invasive plaques build up in the brain, says Hartley. As well as to “look at the basic biology of how things get in and out of the brain.” Blood and saliva tests are also in early phases, though not yet clinically available.

What good will diagnostics do without a drug treatment? Hartley likens them to cholesterol tests for heart disease. “At one point they didn’t think cholesterol was a good marker, it waxed and waned, kind of what we’re doing with amyloid for Alzheimer’s now. We now have data to suggest that amyloid may start accumulating 20 years prior to clinical symptoms. I think we’ll get there with biomarkers or a panel of them that tell you if you are at risk and then show if you’re developing the disease. We need a drug to intervene as early as possible.”

Lifestyle interventions

However, lifestyle interventions show great promise in retaining cognitive function into old age, and even potentially slowing the progression in a person diagnosed with Alzheimer’s. Hartley points to a study done in Copenhagen. “They did the full court press on lifestyle interventions like diet and exercise. Within a two-year period they saw a slowing of cognitive decline. We don’t know which of those things, however, had the most effect.” The next step will be to formulate studies that look at each lifestyle intervention individually to improve cognitive function or slow Alzheimer’s decline.

Hartley’s top three lifestyle tips for women to reduce cognitive decline begins with exercise. “All other risk factors are modified by exercise, such as hypertension, high cholesterol or high glucose levels,” he says.

Next, nutrition is key, especially as high cholesterol may be linked to an increase in amyloid levels.

Third, the data is strong that staying socially and mentally engaged is key to slowing cognitive decline. “What we know about the brain is it works by stimulation—so use it or lose it,” Hartley says. “The more people stay socially and mentally engaged in doing complex tasks, the better the cognition.”

Lastly, staying educated is key. The more aware you are of your baseline level of health and cognitive functioning, the better you can notice changes.  If you, or a loved one over the age of 60, notice cognitive changes in memory or awareness, don’t wait to see your doctor. Fear of a diagnosis could put off important lifestyle changes you’re better off implementing as soon as possible.

Better yet, don’t wait until your cognition declines; take a proactive and preventative approach by adopting regular exercise, healthy eating, and stimulating your brain right now.

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