a higher risk of dementia for women

There is currently no effective treatment for dementia. It is therefore crucial to identify the most effective means of preventing this disease. A new study has found that smoking, diabetes, high body fat, stroke and low socioeconomic status were all equally strong risk factors for dementia in men as in women.

However, hypertension, or high blood pressure, was associated with a higher risk of dementia in women than in men. And this, after the researchers had taken into account the other risk factors. The results suggest that a more personalized approach to treating high blood pressure is warranted. Dementia involves the progressive loss of memory, cognitive abilities and the ability to perform daily tasks.

According to the World Health Organization (WHO), around 50 million people worldwide have dementia. Each year, there are nearly 10 million new cases.
Although there is currently no cure or treatment to slow the progression of the disease, scientists have identified several risk factors.
So, certain lifestyle changes and drug treatments can reduce these risks, helping to prevent the onset of the disease in the first place.

Cardiovascular problems such as high blood pressure have emerged as particularly important risk factors for dementia. A few studies have found that, all other things being equal, hypertension puts women at a higher risk of dementia than men.

Factors that increase the risk of dementia

A new study, which followed more than half a million people, adds to the evidence that high blood pressure in middle age puts women at a higher relative risk of dementia, even when controlling for other risks. The researchers found that smoking, diabetes, high body fat, and low socioeconomic status all have the same impact on dementia risk in men and women. The study, by researchers at the George Institute for Global Health at the University of New South Wales in Newtown, Australia, is published in the journal BMC Medicine.

This study suggests that a more individualized approach to blood pressure treatment in men compared to women may result in even greater protection against the development of dementia.

Half a million volunteers

The researchers followed 502,226 people in the UK Biobank, a biomedical database that recruited volunteers between 2006 and 2010. At the time of recruitment, none of the participants had dementia. Their average age was 56.5 years. Over the next 12 years, 4,068 of them developed dementia.

Smoking, diabetes, high body fat, previous stroke and low socioeconomic status at the start of the study were associated with a similar increase in dementia risk in women and men. However, although the overall incidence of dementia was higher in men than in women, high blood pressure was associated with a higher relative risk in women after controlling for all other risk factors.

Specifically, as men’s systolic blood pressure increased from low to high, their risk of dementia decreased and then increased again, following a U-shaped curve. In contrast, the risk of dementia was higher in women than in men. Dementia risk remained stable in women with low systolic blood pressure and then increased steadily with increasing blood pressure. This type of steady, or linear, increase in risk is sometimes known as a dose-response relationship.

This sex-related risk difference associated with increased blood pressure was apparent for both vascular dementia and Alzheimer’s disease.

Differences in treatment between men and women

The researchers believe their findings may reflect differences in the medical treatment of high blood pressure between men and women. Previous research has suggested that, overall, women take more different medications and are less likely to adhere to recommended usage than men.

While it is plausible that the observed gender differences in blood pressure in relation to dementia risk may be linked to biological differences between women and men, disparities in medical treatment may also offer some explanation. This lack of adherence could be due to women experiencing more unpleasant side effects.

Additionally, the dose-response association between systolic blood pressure and dementia in women may be due to the fact that hypertension is less well managed in women than in men, given lower adherence to treatment in average, worsened by more polypharmacy [prise de plusieurs médicaments] and more treatment-related side effects.


Dementia. WHO

Sex differences in the association between major cardiovascular risk factors in midlife and dementia: a cohort study using data from the UK Biobank

* Presse Santé strives to transmit health knowledge in a language accessible to all. In NO CASE, the information given can not replace the advice of a health professional.

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