How Alzheimer's Differs In Men & Women, From Risk Factors To Preventive Strategies

Alzheimer's disease affects around 6 million people in the United States alone, with an expected 15 million patients by the year 2050. (To put that in context, that's the entire populations of New York, Chicago, and Los Angeles added together). 

However, according to neuroscientist, nutritionist, and associate director of the Alzheimer's Prevention Clinic at Weill Cornell Medical College Lisa Mosconi, Ph.D., there is a huge nuance in the statistics that typically gets overlooked. 

"Almost two-thirds of all those patients might be women," she tells me on this episode of the mindbodygreen podcast. "So for every man suffering from Alzheimer's, there are two women."

Believe it or not, the major risk factor for men is being single. According to Mosconi, men need a support system—studies have shown that men who are not married had a higher risk of cognitive decline. 

While the existing research has only studied the effects on heterosexual married men, Mosconi would argue that a loving relationship—no matter the label—is an important factor for preventing Alzheimer's. As long as men have a support system, Mosconi says, their risk of Alzheimer's can decrease. 

"Physically, men need to be in a relationship," she says. "But just being in a solid, nurturing relationship with your spouse, friend, or partner is actually supportive of your health." 

For women, Mosconi notes that the No. 1 risk factor is their hormonal health, specifically menopause.

"In women who are going through menopause, the brain starts showing reductions in brain energy levels, which correlates with the formation of amyloid plaques, or Alzheimer's plaques, in women's brains," she explains. 

Think of women's hormones as "superpowers" for their brains; once women lose those superpowers during menopause, the brain becomes a little more vulnerable—whereas in men, their testosterone stays pretty stable throughout their lifetime. That said, women might want to check if they are in perimenopause or postmenopause and figure out whether they want to start hormonal therapy, as early as their mid-40s, says Mosconi.

It wouldn't be a podcast on brain health if we didn't mention the Mediterranean diet. In terms of the healthiest eating plan, the Mediterranean diet racks up a ton of points these days. And just like other nutrition experts, Mosconi says the benefits of this vegetable-packed, olive-oil-leaning eating plan are unparalleled when it comes to preventing Alzheimer's. 

"This diet seems to work really well for women and for men," she says. "It's a very sensible diet. It's rich in veggies, fruits, whole grains, and legumes. The omega-3 fatty acids from fish, especially DHA and EPA, are really crucial for brain health." 

"EDCs are very specific chemicals that could be in your household that could potentially disrupt estrogen," Mosconi says. "These compounds are health hazards, especially for pregnant women and young girls. So it's really important that we have hardly any plastic in the house." 

We recognize plastic use as a problem from a sustainability standpoint, but we should also emphasize that the chemicals in plastic can pollute our food, water, and—believe it or not—our hormones. 

All the coffee-obsessives out there will be pleased to know that Mosconi recommends drinking a couple of cups of coffee a day as helpful for preventing Alzheimer's. However, it's a fine line before crossing over to risky territory. Basically, you want to be in that sweet spot of a coffee buzz—not too much and not too little. 

"If you drink no coffee, your risk of Alzheimer's disease is as high as that of a person who drinks a ton of coffee," Mosconi says. "But if you're right in the middle, which is about two cups of coffee a day, that seems to be really helpful." 

Another caveat, according to Mosconi, is that the response to caffeine depends on women's menstrual cycles. Ever feel like you just can't get that caffeine buzz, even after four or five cups? That's because you're probably in the second part of the menstrual cycle, where you're progesterone is higher and inhibiting that response to the stimulant. 

Finally, Mosconi believes in the importance of exercise. When it comes to hitting the gym, Mosconi says that the time (and sweat) you put in is truly an investment. 

"Especially for women, if you have a decent level of fitness throughout your lifetime, your risk of dementia is low when you are in your 70s and 80s," she notes.

That said, she recognizes the importance of exercising from a young age and suggests that you get moving. Whether it's HIIT, yoga, or a simple walk through the neighborhood, moving your body has long-lasting effects on your brain health.