Sex, Gender, and the Decline of Dementia

Research output: Chapter in Book/Report/Conference proceedingChapter


The incidence rate of dementia and Alzheimer’s disease (AD) has declined in high-income countries over the past 25 years. In this chapter, I provide a narrative review of new ideas and concepts related to the impact of sex and gender differences on the declining risk of dementia. In particular, I discuss three examples of risk factors related to sex and gender that have probably contributed to the trend. Apolipoprotein E genotype is equally common in men and women but has a stronger effect in women. Apolipoprotein E genotype is a biological factor that cannot be modified but interacts with sex- or gender-related factors that have changed over time. Low education is believed to have a similar harmful effect in men and women but has been historically more common in women. Therefore, education is a social factor related to gender that has contributed to the time trends. Bilateral oophorectomy is a surgical practice restricted to one sex that has changed over time. Consideration of risk and protective factors in men and women separately may accelerate etiologic research for neurological diseases in general, and for dementia and AD in particular, and may explain the observed differences in time trends across countries. Similarly, future preventive interventions for dementia should be tailored to men and women separately.

Original languageEnglish (US)
Title of host publicationInternational Society of Gynecological Endocrinology Series
PublisherSpringer Nature
Number of pages14
StatePublished - 2019

Publication series

NameInternational Society of Gynecological Endocrinology Series
ISSN (Print)2197-8735
ISSN (Electronic)2197-8743


  • APOE genotype
  • Alzheimer’s disease
  • Dementia
  • Education
  • Gender
  • History
  • Oophorectomy
  • Sex

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Obstetrics and Gynecology
  • Reproductive Medicine


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