Alzheimer’s disease is frequently linked to women, primarily due to their representation in the majority of diagnosed cases. However, recent research has uncovered an important distinction: although a greater number of women develop Alzheimer’s, men may undergo a significantly more rapid decline once the disease manifests.

A study published in Alzheimer’s & Dementia indicated that men exhibiting early signs of Alzheimer’s—characterized by the accumulation of amyloid plaques in the brain—demonstrated more pronounced declines in brain health, cognitive abilities, and critical biological markers of the disease when compared to women. In summary, once Alzheimer’s takes hold in men, its progression may occur at a notably faster pace.

A faster decline in men?

Recent research has shifted its focus from the general prevalence of Alzheimer’s disease in women compared to men to the developments that occur following the initial biological indicators of the condition. The study utilized data from the Baltimore Longitudinal Study of Aging, which has been monitoring older adults since 1958, incorporating brain imaging and cognitive assessments conducted over the years.

Of the 78 participants who showed early amyloid buildup, men experienced significantly faster changes in Alzheimer ’s-related biomarkers and brain structure. Specifically, they had:

• Higher levels of tau protein, which is associated with brain cell damage.
• Faster brain shrinkage is a key marker of Alzheimer’s progression.
• Steeper declines in cognitive abilities, particularly in visual-spatial skills and executive functions like decision-making and planning.

Although the study did not definitively prove that men progress to full-blown dementia more quickly, the findings strongly suggest that their disease trajectory is more aggressive than women’s once the process begins.

What this means for you

These findings could change how we think about Alzheimer’s prevention and treatment. Since men may experience a faster progression, early detection and intervention could be even more crucial for them.

Here’s what you can do to support long-term brain health, regardless of gender:

• Prioritise regular check-ups – Cognitive screenings and brain scans may help catch early warning signs.
• Stay mentally and physically active – Exercise, social engagement and brain-stimulating activities have been linked to slower cognitive decline.
• Manage cardiovascular health – High blood pressure, cholesterol and diabetes are major risk factors for Alzheimer’s.
• Follow a brain-friendly diet – The Mediterranean diet, rich in healthy fats and antioxidants, has been shown to support brain function.

The future of Alzheimer’s research

While this study highlighted sex differences in Alzheimer’s progression, it also raises new questions - why do men seem to decline faster once amyloid buildup starts? Could hormones, genetics, or lifestyle factors play a role? Researchers hope that by understanding these differences, they can develop more personalised treatment strategies for both men and women.

For now, the key takeaway is clear: Alzheimer’s affects men and women differently and recognising these differences could be a game-changer in how we approach brain health. If you or a loved one is at risk, proactive steps today may help protect cognitive function in the years to come.

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