Alzheimer’s disease is common among older adults, and the seventh leading cause of death in the United States overall. But its prevalence (the proportion of people within the population who have it) is much higher among women compared to men. In fact, about two-thirds of U.S. adults with Alzheimer’s are female.
One reason is that women often outlive men, giving them a longer window of opportunity to develop Alzheimer’s, explains Margo Block, DO, a neurologist in Kansas City, Kansas. Alzheimer’s disease mostly affects older adults, and age is the biggest risk factor for the disease.
But even without age factored in, women remain more likely to develop the condition. Some experts point to other biological, genetic, and lifestyle differences in males and females as possible factors. These include the following.
- Genetic changes are a significant risk factor Alzheimer’s disease and could be an important difference. For instance, men and women are equally as likely to carry an Alzheimer’s-related gene variant in the ApoE4 gene. But the changes in this gene seem to affect women more.
- Hormonal shifts such as menstruation, pregnancy, and menopause cause changes in exposure to estrogen, which affects brain health. This shift may play a role in Alzheimer’s disease.
- Access to education and skilled work may help protect against Alzheimer’s, since they’re believed to stimulate the brain. Compared to men in their age groups, many women haven’t had the same opportunities in these areas.
Some experts are looking at the effects of high blood pressure and physical activity patterns, as well.
More research is needed to determine how sex plays a role in Alzheimer’s risk. The way research is often performed can be a challenge, however. Many studies on the disease are not designed to tease out specific differences based on sex, and they often have included few—or even no—female participants.
Sex and Alzheimer’s diagnosis
In addition to risk, sex may play a role in the diagnosis of Alzheimer’s. Men may be diagnosed with Alzheimer’s more promptly than women in certain circumstances, allowing them to receive treatment sooner.
One potential reason for this is differences in communication. “Women are generally known for their advanced verbal skills,” says Dr. Block. “So there may be a significant amount of brain function loss before it becomes apparent to loved ones that something’s wrong.” Since screening tests are largely based on verbal memory skills, women may be able to mask their symptoms until they’re further along in the disease course, too.
Another reason women may be diagnosed later: “Insomnia or depression may appear to cause memory problems when it’s actually Alzheimer’s,” says Dr. Block. “I frequently see women complaining of mood issues or difficulty sleeping—more so than their male counterparts," she adds. "Women may just assume ‘stress’ is the cause of their symptoms.”
Get help for these red flags
“If a woman or her family members notice the early warning signs of Alzheimer’s, they should ask for a screening examination from her primary care physician,” says Dr. Block. “If her doctor has concerns based on those results, she’ll likely be referred to a neurologist for further evaluation.”
Make an appointment with your healthcare provider (HCP) if you experience:
- Mood swings or personality changes
- Insomnia
- Concentration problems
- Trouble planning, making decisions, or managing usual daily tasks
- Difficulties storing new information
- Difficulty speaking, reading, or writing
- Problems with memory
These red flags may be early signs of dementia, but they could also indicate mild cognitive impairment (MCI). MCI involves changes to thinking abilities that don’t always progress to Alzheimer’s. Some people with this condition may experience symptoms that stay relatively the same or improve over time.
Regardless of whether your symptoms are due to MCI, Alzheimer’s, or another condition like depression, it’s essential to see your HCP right away. Doing so allows you to measure your thinking abilities periodically. That can help you and your HCP determine whether your symptoms are changing over time and can help ensure you receive the best possible treatment.
Although there’s no cure for Alzheimer's, some medications can:
- Ease symptoms
- Improve quality of life
- Help a person maintain independence for as long as possible
When treatment is delayed, Alzheimer’s may progress or worsen at a faster pace than it would with the right medications.
“I frequently hear women brush off their symptoms by saying things like, ‘Everybody my age has this, it’s normal,' or, 'Of course, I know the answer to that question,’” says Block. But while facing symptoms head-on may be intimidating, doing so can protect your quality of life and independence in the long run.
Sources: National Institute on Aging. Alzheimer's... + 7
- National Institute on Aging. Alzheimer's disease fact sheet. April 5, 2023.
- Alzheimer’s Association. Women and Alzheimer’s. Accessed January 30, 2025.
- Alzheimer’s Society. Why is dementia different for women? March 8, 2024.
- Harvard Medical School. Why are women more likely to develop Alzheimer's disease? January 20, 2022.
- Alzheimer’s Research UK. Why women are bearing more of the impact of dementia. May 15, 2022.
- Aggarwal NT, Mielke MM. Sex differences in Alzheimer's disease. Neurol Clin. 2023 May;41(2):343-358.
- National Institute on Aging. What is dementia? Symptoms, types, and diagnosis. December 8, 2022.
- National Institutes of Health. Lack of sleep in middle age may increase dementia risk. April 27, 2021.
