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Are Women at Higher Risk of Dementia? A Rotterdam Observational Study

Background: The Rotterdam Study is a population-based study ongoing since 1990 in the city of Rotterdam in The Netherlands. It was a response to the changing demographics leading to an increase of elderly in most populations. Follow-up studies have been effective in finding causes of heart disease and cancer.

Dementia risk is increasing worldwide. An observational population-based study from Rotterdam found that there was a higher risk of dementia in Dutch women versus men (25.9% vs 13.7%). Rates of stroke were similar between women and men. The women had a higher lifetime risk of developing dementia (1 in 3 for women vs 1 in 5 for men).

Is Greater Life Expectancy a Factor?

One can’t help but wonder why these Dutch women had an increased risk of developing dementia as compared to risk of stroke.

The authors of this study speculated that this discrepancy may be due to the fact that women in the Rotterdam study had a higher life-expectancy than men (83.5 years vs 81.7 years for men).

“With longer life-expectancy, individuals (women) in this study simply had more time to develop (dementia) in a timeframe with high age-specific incidence rates.”

The authors also pointed out that the women in this study “were substantially lower educated compared to men, which may have led to a lower dementia resilience in women.”

Gender-Specific Interventions to Reduce Risk of Dementia

Unfortunately, there aren’t any medicines that can cure dementia or slow it down. But there are treatments to help ease some of its symptoms.

The good news: In high income countries, there is a declining number of people developing dementia. This may be due to preventive strategies such as better vascular risk factor management, improved educational attainment, and other public health developments that improve the resilience for dementia.

The authors recommend gender-specific interventions to help reduce the risk of dementia. For example, support for women suffering from loneliness and depression and dietary counseling for men.

Editor’s Comments
Editor's Comments about Cecelia's A-Fib story
Developing Dementia is Related to Aging Not Gender: This observational study does not imply that women are genetically inferior to men with regard to the risk of developing dementia. Developing dementia is related to aging, and women, in general, do live longer than men.
Loneliness and Depression Risk Factors for Dementia: I correspond with a woman with A-Fib who recently lost her husband. He died way too young. She is still devastated by the loss.
It happens all too often. Women out living their husband/life companion of many years.

Though a non-genetic factor, loneliness and depression certainly are risk factors for dementia. As a society we need to recognize what many older women experience and offer support.

Resources for this article
• Licher, S. et al. Lifetime risk of common neurological diseases in the elderly population. J Neurol Neurosung Psychiatry. 2019;90:148-156. https://jnnp.bmj.com/content/90/2/148 . doi: 10.1136/jnnp-2018-318650.

• Bunch, T. Jared. Cognitive Decline and Dementia in Patients with Atrial Fibrillation: Update on the CAF and PLUG Dementia Trials. EP Lab Digest. January 2020, vol. 20, no 1. P. 1.

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