title: Sex and gender differences in the causes of dementia: a narrative review.
abstract: This is a narrative review of new ideas and concepts related to differences between men and women in their risk of developing dementia or Alzheimer's disease (AD). We introduce the concept of dimorphic neurology and the distinction between sex and gender. We then provide three examples of risk factors related to sex and gender from the literature. 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 can be modified. Low education has a similar harmful effect in men and women but has been historically more common in women. Education is a social factor related to gender that can be modified. Finally, bilateral oophorectomy is a factor restricted to women. Bilateral oophorectomy is a surgical practice related to sex that can be modified. 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. Similarly, future preventive interventions for dementia should be tailored to men and women separately.
authors: Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, 200 First Street, Rochester, MN 55905, USA; Department of Neurology, Mayo Clinic, 200 First Street, Rochester, MN 55905, USA. Electronic address: rocca@mayo.edu.
authors: Walter A
authors: WA
authors: Rocca
authors: Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, 200 First Street, Rochester, MN 55905, USA; Department of Neurology, Mayo Clinic, 200 First Street, Rochester, MN 55905, USA. Electronic address: mielke.michelle@mayo.edu.
authors: Michelle M
authors: MM
authors: Mielke
authors: Department of Radiology, Mayo Clinic, 200 First Street, Rochester, MN 55905, USA. Electronic address: vemuri.prashanthi@mayo.edu.
authors: Prashanthi
authors: P
authors: Vemuri
authors: Department of Surgery, Physiology and Biomedical Engineering, Mayo Clinic, 200 First Street, Rochester, MN 55905, USA. Electronic address: miller.virginia@mayo.edu.
authors: Virginia M
authors: VM
authors: Miller
mesh_terms: D000544:Alzheimer Disease / Q000209:etiology / Q000235:genetics*; D001057:Apolipoproteins E / Q000235:genetics*; D003704:Dementia / Q000209:etiology / Q000235:genetics*; D004522:Educational Status; D005260:Female; D005783:Gender Identity; D020022:Genetic Predisposition to Disease; D005838:Genotype; D006801:Humans; D008297:Male; D010052:Ovariectomy / Q000009:adverse effects*; D012307:Risk Factors; D012727:Sex Characteristics; D012737:Sex Factors
chemical_list: D001057:Apolipoproteins E
keywords: APOE genotype; Dementia; Education; Gender; Oophorectomy; Sex