Did you know that more women get affected by dementia globally than men do? In fact, studies suggest that women with dementia outnumber men with dementia by two to one! Given the fact that dementia is a disease that comes around with age, and the fact that women tend to live longer than men, raising awareness about how this affects women globally is very important. India’s National Health Portal reveals that the prevalence of dementia in India is 2.7 per cent, and the average age at which it is diagnosed is 66.3 years (which is about 10 years less than in developed countries).
This suggests that for Indian women, and people in their friend or family circles, there is an urgent need to be even more cautious about dementia. This can only be achieved by knowing more about this disease which affects the brain, and finding out how to diagnose, treat, and even prevent it. Here is everything you should know.
Gender disparities in dementia
Dementia is usually the term used to describe a state of being where your memory, thinking, behaviour, and social abilities are affected severely enough to interfere with your life and cause a low standard of living. It is usually considered to be a disease by people, but in fact, dementia is a set of debilitating symptoms that are caused by several diseases, like Alzheimer’s disease, Parkinson’s disease, Huntington’s disease, Creutzfeldt-Jakob disease, and traumatic brain injury (TBI). It can also be caused by hematomas, nutritional deficiencies, metabolic disorders, hormonal disorders, brain tumours, and severe or untreated infections.
According to a 2020 study published in the journal BMC Psychiatry, while the higher lifetime risk of dementia in women is usually linked to their longer life expectancy, the impact of gender inequalities can have a larger role to play than previously assumed. The study says that socio-economic disparities, lower access to important resources like education, nutrition, healthcare, etc can exacerbate important risk factors associated with dementia. These disadvantages, which are more acutely felt by women in developing nations, can not only lead to physical health problems, but also mental health ones like anxiety, depression, and social isolation.
Another factor that adds to the higher burden of dementia among women, as the Alzheimer’s Society of the UK points out, is the crucial hormone called oestrogen, which is more popularly known as the female hormone. Women have a lifelong relationship with oestrogen, so, naturally, their health is affected by its levels in the body and the brain. Some studies suggest that women who have higher levels of oestrogen throughout their life are at a lower risk of dementia. Others state that when the levels of oestrogen deplete during perimenopause and menopause (especially in the absence of any medical or nutritional support through this important stage of life), it can cause dementia during the 60s.
Risk factors for dementia
So, it’s quite evident that whether it’s due to socio-economic inequalities or the role of oestrogen, the fact remains that women are at a higher risk of developing dementia when they age. Now, the thing we next need to understand is who is at risk? Women who have any of the following risk factors for dementia are at a higher risk of developing the health issue as they age.
A family history: Some studies suggest that genetics can play a role in increasing your risk of dementia, especially if someone in your family suffers from diseases like Alzheimer’s or Parkinson’s. However, not everyone in the same family may carry the genetic mutations for these neurocognitive diseases, and you can get tested for the same if you think you may have a risk.
Down syndrome: The Mayo Clinic suggests that by the time they reach their middle age, people with Down syndrome run a very high risk of developing early-onset Alzheimer’s. This, in turn, can increase their risk of developing dementia.
Nutritional deficiencies: An unhealthy diet can often lead to nutritional deficiencies which can affect brain function, speed up cognitive ageing, and cause dementia. Low levels of essential vitamins and minerals, like vitamin D, vitamin B6, vitamin B12, folate, sodium, potassium, and iron have been linked with dementia.
Heart disease and diabetes: If you have diabetes, whether it’s type 1 or type 2, your risk of developing dementia when you grow old is higher. The same goes for people with heart diseases.
Metabolic syndrome: This refers to a cluster of conditions that can increase your risk of developing heart disease, stroke and type 2 diabetes, which in turn may lead to dementia as you age. If you suffer from high blood pressure, high cholesterol, atherosclerosis (build-up of fats in your artery walls), or obesity, you may run a high risk of developing dementia.
Smoking and alcohol abuse: Smoking increases your risk of developing blood vessel disorders and hormonal imbalance, which in turn increases your risk of dementia. Similarly, substance and alcohol abuse can cause damage to the brain cells, which in turn can lead to a higher risk of dementia.
Exposure to air pollution: Recent studies have shown that air pollutants, especially particulate matter or PM pollutants, can break through the blood-brain barrier and damage the brain cells. Air pollution exposure is therefore linked to a higher risk of dementia and neurocognitive disorders.
Mental health issues: While the link between anxiety disorders, depression, and dementia is not fully understood by science yet, the fact remains that people with mid-life or late-life mental health issues do run a higher risk of developing dementia.
Sleep disorders: If you suffer from sleep apnea, sleep disturbances, or night terrors, it can affect your brain cells, which in turn can increase your risk of dementia at a later age.
Head trauma: The fact that severe head trauma and TBI can cause brain damage is well known. Some studies show that this can increase your risk of developing dementia, especially within the first six months of a TBI.
Medications: Studies show that excessive use of over-the-counter sleeping pills and some other medications can increase your risk of developing dementia.
Warning signs to look out for
Conditions like dementia do not develop in a single day. There are often plenty of warning signs that show up, especially as people cross their 50s and enter the 60s. The US Centers for Disease Control and Prevention (CDC) mentions the following as the key warning signs to look out for:
• Loss of memory, like forgetting things or repeating yourself, which disrupts daily life and activities.
• Challenges in completing tasks that involve problem-solving capabilities.
• Difficulties in completing habitual, familiar tasks like cooking, bathing, driving, etc.
• Confusion about time or place, or both.
• Trouble understanding visual and spatial relations, leading to tripping, losing balance, dropping things, spilling, etc.
Caring for women with dementia
It is a global fact that the burden of caregiving falls on women more than men, and when it comes to a health issue as debilitating as dementia, this can be even more difficult. Getting a proper and timely diagnosis, medications that can help manage the condition, and regularly consulting a doctor are all key components of caregiving here. It’s also important to get nutrient levels, hormones and blood levels checked at regular intervals, because low levels of any of these can lead to exaggerated symptoms and make caregiving more difficult. Most healthcare experts from around the world recommend making a guided routine with simple activities for people with dementia. It would be best if you sit with your primary care physician or specialist, and create such a routine of care for the patient.
Preventive measures every woman can take
There is no sure-shot way of preventing dementia, but every woman can take certain preventive measures to reduce the risk of developing this condition. The Mayo Clinic recommends the following:
Maintain a healthy, balanced diet. Some studies show that the Mediterranean diet, which is rich in fruits, vegetables, whole grains, fish, nuts and seeds, is one of the best in the world to prevent nutritional deficiencies as well as cardiovascular diseases.
• Keep your brain active by engaging in mentally stimulating activities. This could be anything from reading, painting or cooking to playing memory games and solving puzzles.
• Get at least 150 minutes of medium- to high-intensity exercise every week, and try to be as active as possible.
• Make sure you are socially active and have plenty of interaction with people every week. Social isolation should be prevented at all ages.
• Get enough vitamins, especially vitamin D. If you don’t get enough of these through a balanced diet, then talk to your doctor about getting dietary supplements according to your individual needs.
• Manage your cardiovascular risk factors, like blood pressure, cholesterol, weight, and blood sugar levels.
• Quit smoking.
• Consume alcohol in moderation. The Mayo Clinic and many recent studies explain that moderate alcohol consumption refers to a small drink in one day for women, and any more than that is overconsumption.
• Get treatment for any disease you have, whether it’s to do with your physical health or your mental health.
• Make sure you get enough sleep and consult a doctor if you face any sleep-related issues.