Cleveland Clinic, Lou Ruvo Center for Brain Health, Las Vegas, Nevada.
Providence Swedish Center for Healthy Aging, Swedish Neuroscience Institute, Seattle, Washington, USA.
Curr Opin Obstet Gynecol. 2023 Apr 1;35(2):169-175. doi: 10.1097/GCO.0000000000000849. Epub 2023 Jan 31.
Poor cognitive aging and dementia pose a significant public health burden, and women face unique risks compared to men. Recent research highlights the role of genetics, menopause, chronic disease, and lifestyle in risk and resilience in women's cognitive aging. This work suggests avenues for clinical action at midlife that may change the course of brain health in aging.
Studies indicate women's risk for poor cognitive aging relates in part to hormone changes at menopause, a time when memory, brain structure and function, and Alzheimer's pathology may be observed in women and not men. Medical and lifestyle risks including diabetes, hypertension, and low physical activity also contribute to women's unique risks. At the same time, literature on resilience suggests women may benefit from lifestyle and chronic disease intervention, possibly more than men. Current studies emphasize the importance of interacting genetic and lifestyle risks, and effects of social determinants of health.
Women have greater risk than men for poor cognitive aging; however, by treating the whole person, including genetics, lifestyle, and social environment, clinicians have an opportunity to support healthy cognitive aging in women and reduce the future public health burden of dementia.
认知能力衰退和痴呆对公共健康造成了重大负担,与男性相比,女性面临着独特的风险。最近的研究强调了遗传、更年期、慢性疾病和生活方式在女性认知衰老风险和适应能力中的作用。这些研究为中年时期的临床干预提供了途径,可能改变大脑健康衰老的进程。
研究表明,女性认知能力衰退的风险部分与更年期的激素变化有关,此时女性可能会出现记忆力下降、大脑结构和功能变化以及阿尔茨海默病病理,而男性则不会。糖尿病、高血压和低身体活动等医疗和生活方式风险也导致了女性的独特风险。与此同时,关于适应能力的文献表明,女性可能比男性更受益于生活方式和慢性疾病干预。目前的研究强调了遗传和生活方式风险的相互作用以及健康决定因素的重要性。
女性认知能力衰退的风险高于男性;然而,通过治疗整个人,包括遗传、生活方式和社会环境,临床医生有机会支持女性的健康认知衰老,并减少未来痴呆症的公共健康负担。