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心血管因素与痴呆症的关系:探讨性别差异及女性特有因素。

Cardiovascular contributions to dementia: Examining sex differences and female-specific factors.

作者信息

Wood Alexander Madeline, Paterson Jane, Arvanitakis Zoe, Black Sandra E, Casaletto Kaitlin B, Christakis Marie K, Einstein Gillian, Galea Liisa A M, Harwood Leila, Kirkham Amy, Mitchell Sara, Pa Judy, Perri Lucas, Splinter Tallinn F L, Swardfager Walter, VandeBunte Anna M, Rabin Jennifer S

机构信息

Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, Ontario, Canada.

Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, 500 University Ave, Toronto, Ontario, Canada.

出版信息

Alzheimers Dement. 2025 Aug;21(8):e70610. doi: 10.1002/alz.70610.


DOI:10.1002/alz.70610
PMID:40851413
Abstract

Growing evidence underscores the importance of cardiovascular contributions to Alzheimer's disease and related dementias (AD/ADRD). While sex differences in cardiovascular disease (CVD) risk factors and outcomes are well established, the question of whether vascular contributions to AD/ADRD vary by sex has only recently garnered attention. In this narrative review, we discuss sex differences in conventional CVD risk factors (e.g., hypertension, dyslipidemia, diabetes), as well as underrecognized female-specific (e.g., menopause history, polycystic ovary syndrome, adverse pregnancy outcomes) and female-predominant (e.g., autoimmune conditions, breast cancer) CVD risk factors. Despite their relevance, these sex-specific considerations are rarely incorporated into current approaches to quantify CVD risk in AD/ADRD research. We offer recommendations to address these gaps and promote the use of sex-informed methods for studying cardiovascular contributions to AD/ADRD in women, which is essential for developing precision strategies to improve outcomes for all individuals at risk of dementia. HIGHLIGHTS: There are extensive sex differences in cardiovascular risk, dementia risk, and their interrelationships. Many cardiovascular risk factors confer greater risk for dementia in women than men. Existing approaches to quantifying cardiovascular risk often overlook sex differences and female-specific factors. Sex-informed approaches are essential for an accurate understanding of cardiovascular contributions to dementia.

摘要

越来越多的证据强调了心血管因素对阿尔茨海默病及相关痴呆症(AD/ADRD)的重要性。虽然心血管疾病(CVD)危险因素和结局存在性别差异已得到充分证实,但血管因素对AD/ADRD的影响是否因性别而异这一问题直到最近才受到关注。在这篇叙述性综述中,我们讨论了传统CVD危险因素(如高血压、血脂异常、糖尿病)中的性别差异,以及未得到充分认识的女性特异性(如绝经史、多囊卵巢综合征、不良妊娠结局)和女性主导(如自身免疫性疾病、乳腺癌)的CVD危险因素。尽管它们具有相关性,但这些性别特异性因素在目前AD/ADRD研究中量化CVD风险的方法中很少被纳入。我们提出了一些建议来填补这些空白,并促进使用考虑性别的方法来研究心血管因素对女性AD/ADRD的影响,这对于制定精准策略以改善所有有痴呆风险个体的结局至关重要。要点:心血管风险、痴呆风险及其相互关系存在广泛的性别差异。许多心血管危险因素在女性中导致痴呆的风险高于男性。现有的量化心血管风险的方法往往忽略了性别差异和女性特异性因素。考虑性别的方法对于准确理解心血管因素对痴呆的影响至关重要。

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本文引用的文献

[1]
Uptitration of statin therapy in women and men: a population-based cohort study.

Eur Heart J Qual Care Clin Outcomes. 2025-4-17

[2]
Preservation of Vascular Endothelial Function in Late-Onset Postmenopausal Women.

Circ Res. 2025-2-28

[3]
Unraveling the bidirectional link between cancer and dementia and the impact of cancer therapies on dementia risk: A systematic review and meta-analysis.

Alzheimers Dement. 2025-2

[4]
Early life exposure to structural sexism and late-life memory trajectories among black and white women and men in the United States.

Alzheimers Dement. 2025-2

[5]
Leveraging research into sex differences and steroid hormones to improve brain health.

Nat Rev Endocrinol. 2025-4

[6]
Sex-Specific Vulnerabilities to Subclinical Vascular Brain Injury in Early Late-Life: The Framingham Heart Study.

Ann Neurol. 2025-3

[7]
Sex-specific risk factors and clinical dementia outcomes for white matter hyperintensities in a large South Korean cohort.

Alzheimers Res Ther. 2024-11-1

[8]
Sex-specific age-related differences in cerebrospinal fluid clearance assessed by resting-state functional magnetic resonance imaging.

Neuroimage. 2024-11-15

[9]
Cardiac Contributions to Brain Health: A Scientific Statement From the American Heart Association.

Stroke. 2024-12

[10]
Menopause and MHT in 2024: addressing the key controversies - an International Menopause Society White Paper.

Climacteric. 2024-10

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