Women, Brain Health, and the Alzheimer’s Puzzle

Alzheimer’s disease is often thought of as a disease of aging, but scientists are increasingly recognizing that biology also plays an important role. For women, the risk appears to be significantly higher. To better understand what researchers are learning, we asked Lauren Oberlin, PhD, an investigator at the AdventHealth Research Institute, to answer some of the most important questions about women and brain health.

Many people do not realize that Alzheimer’s disease affects women differently than men. What do we know about that today?

Dr. Oberlin:
One of the most striking facts about Alzheimer’s disease is that women are disproportionately affected. In the United States, nearly two thirds of people living with Alzheimer’s are women. That means roughly twice as many women as men are living with the disease. For researchers, that statistic raises an important question. Why are women at greater risk?

For years people assumed the explanation was simple because women live longer. Is that still the thinking?

Dr. Oberlin:
That was the common explanation for a long time, but research now shows that lifespan alone does not explain the difference. Women do tend to live longer on average, but longevity accounts for only part of the increased risk. Scientists now believe other biological factors are involved, including differences in hormones, immune function, and genetics that may influence how Alzheimer’s disease develops.

Why has it taken so long for researchers to focus on these differences between men and women?

Dr. Oberlin:
Historically, biomedical research did not consistently examine sex differences when studying disease. A widely cited paper published in Alzheimer’s and Dementia highlighted this gap and called attention to how poorly sex specific factors had been integrated into Alzheimer’s research. That lack of focus has limited our understanding of the disease and may have slowed progress in developing effective treatments.

What kinds of biological differences are scientists now investigating?

Dr. Oberlin:
Researchers are exploring several possible mechanisms. Hormonal changes, particularly those that occur during menopause, may influence brain health and Alzheimer’s risk. Scientists are also studying how the immune system behaves differently in women and how certain genes associated with Alzheimer’s disease may affect women and men in different ways. These factors likely interact in complex ways that we are only beginning to understand.

Scientists are starting to uncover clues about what may drive this difference in risk. What are some of the most interesting discoveries emerging from research right now?

Dr. Oberlin:
One exciting area of research is identifying biological mechanisms that may contribute to the higher risk we see in women. Scientists are beginning to find evidence that certain pathways in the brain and immune system may function differently in women compared with men. When researchers can identify these mechanisms, it helps us better understand how the disease develops and where new opportunities for prevention or treatment may exist.

Why is understanding the reason behind this difference so important for treatment?

Dr. Oberlin:
Alzheimer’s disease is complex, and treatments that work for one group of people may not work the same way for another. If researchers can identify the biological pathways that increase risk in women, it may allow us to develop therapies that are more precise and more effective. Understanding these mechanisms is a critical step toward more personalized approaches to brain health.

What should women take away from this research right now?

Dr. Oberlin:
One of the most important messages is that brain health is closely connected to overall health. Factors such as cardiovascular health, metabolic health, sleep, physical activity, and cognitive engagement all influence how the brain ages. While scientists continue to study the biology behind Alzheimer’s risk, there are already many steps women can take to support brain health throughout their lives.

How is the AdventHealth Research Institute contributing to this work?

Dr. Oberlin:
Researchers at the AdventHealth Research Institute are working to better understand how biological, metabolic, and lifestyle factors influence brain health across the lifespan. By studying these connections, the goal is to identify new opportunities for earlier detection, prevention, and more personalized care for conditions like Alzheimer’s disease.

Lauren E. Oberlin, PhD is a researcher at the AdventHealth Research Institute studying how metabolism, hormones, and aging influence brain health in women.