Yale neurologist explains women may be at greater risk than men for Alzheimer's disease for this reason

Dr Carolyn Fredericks suggested that women may be at a greater risk due to a combination of biological and other factors. Here's what you need to know.

Alzheimer's is a neurodegenerative disease, and the most common form of dementia, accounting for 60-70 percent of cases, according to World Health Organisation. In a November 25, 2024 video shared on Instagram by Yale School of Medicine (YSM), Dr Carolyn Fredericks, a YSM neurologist who specialises in diagnosing and treating patients with cognitive and behavioural concerns, spoke about the potential sex-based differences in brain connectivity that may influence Alzheimer's disease progression.

Alzheimer's risk in women

In the video, Dr Fredericks highlighted that women exhibit tighter connections in the posterior default mode network compared to men, a pattern that peaks around age 50 and strikingly resembles scans of individuals with preclinical Alzheimer's. While this increased connectivity correlates with better memory performance, Dr Fredericks hypothesised it might represent a 'wear and tear' effect, making these networks more vulnerable to neurodegeneration later on.

She said, “The default mode network, which is this network that's really important for memory and seems to be especially targeted by Alzheimer's disease, is much more tightly connected in the back parts of it in women than in men. And again, that difference peaks right around age 50. It looks a lot like if you look at scans of people who are amyloid positive, preclinical Alzheimer's disease, so they have a positive amyloid scan, but they don't yet have any symptoms. Their scans look very similar. Again, this kind of tightening of the connections in the back part of this network.”

Dr Fredericks added, “So, it's very interesting that increased connectivity actually correlates with doing really well in memory tests. So, in a way, it's an effective it's an effective tool. It's working. But it may be sort of like a highway that gets a lot of wear and tear and then becomes more vulnerable down the road compared to one that hasn't been used quite as much.”

Does Alzheimer's affect men and women differently?

The doctor shared that research aim to understand how these functional network variations in men and women relate to the accumulation of tau protein, a key marker of Alzheimer's, and contribute to the observed more aggressive disease progression in women.

Dr Fredericks said, “So, that's something that we're trying to unpack. We want to look at the relationship between functional networks and that pathological protein tangle that I mentioned and try to understand how women and men might vary in the composition and properties of these networks and how that might contribute to more aggressive progression of tau in women.”

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