June 2017
In This Issue
Women & Alzheimer's disease 

Institute Happenings 

Upcoming Events 
  Recent Blogs 
Dear Friends, 

Alzheimer’s disease and other forms of dementia are particularly devastating for those affected and their loved ones. But, did you know that women are more likely to bear the burden of disease? Women have a greater lifetime risk of developing Alzheimer’s disease compared to men, and two-thirds of caregivers for those with Alzheimer’s disease or dementia are women [1].

June is Alzheimer’s Disease and Brain Awareness Month, so in this issue, we will review some of the latest information and research on Alzheimer’s disease, with a specific focus on its impact on women.  

Nicole C. Woitowich, PhD 
Director of Science Outreach and Education  

Women & Alzheimer's Disease
Alzheimer’s disease is the most common form of dementia which currently affects over 5.5 million people within the United States.  As life expectancy continues to increase, the number of individuals with Alzheimer’s disease is projected to reach 14 million by the year 2050 [2]. These numbers are staggering, and especially concerning, when you consider that women account for two-thirds of Americans with Alzheimer’s [1].  

Alzheimer’s disease and other forms of dementia are typically considered age-related disorders, most often affecting those 65 years or older.  On average, women tend to live longer than men, so it can be easy to assume that a woman’s increased longevity explains the higher risk of age-related disease. However, we know that women have an elevated risk of developing Alzheimer’s disease even when compared to men of the same age [3].

What factors predispose women to Alzheimer’s disease? Likely, it is a combination of genetics, hormones, and lifestyle choices. Below we take a closer look into each of these areas: 
Over the last several decades, scientists have identified key genes which are involved in the progression of Alzheimer’s disease. One gene variant, apolipoprotein E4 (APOE4), has been shown to increase a person’s risk for developing Alzheimer’s disease. Not all people who carry this gene variant will go on to develop Alzheimer’s disease, but approximately 60% of individuals with Alzheimer’s disease are carriers of APOE4 [4]. Interestingly, women with the APOE4 gene variant are more likely to develop Alzheimer’s disease or mild-cognitive impairment compared to men [4,5]. Yet, more research is needed to uncover exactly how the APOE4 gene impacts men and women differently. 
Did you know that in addition to increased disease prevalence, women with Alzheimer's may experience faster cognitive decline? [17]
The primary female hormone, estrogen, has been shown to have a “neuroprotective,” effect on the brain, in both animal and human studies [reviewed in 6, 7]. Yet, once a woman enters menopause, her estrogen levels drop to similar or lower levels than found in men. Could the depletion of estrogen in post-menopausal women tip the balance and promote the formation of Alzheimer’s disease in women? The evidence is conflicting: Some studies have shown that hormone replacement therapy can help prevent or delay the onset of Alzheimer’s disease in women [8, 9], while others claim that it shows no benefit or can actually increase a woman’s risk [10, 11]. The variability in the timing and type of hormone replacement therapy used in clinical studies may have led to these contradictory results. Additional studies are needed to explore how estrogen influences Alzheimer’s disease prevention or progression.  

The hallmark of Alzheimer’s disease is a progressive loss of cognitive function, so much attention has been paid to factors which might affect our cognition such as education, occupation, physical activity, or other lifestyle choices. Several studies have found that “intellectual enrichment,” such as engaging in brain-stimulating activities or obtaining higher levels of education may lower the risk of developing Alzheimer’s disease [12, 13]. However, we know that women throughout the early- to mid-20th century did not have the same access to educational and career opportunities as men.  Exercise has also been shown to improve cognitive function and may slow the rate of cognitive decline in people with Alzheimer’s disease [Reviewed in 14, 15]. Yet, men are more likely to participate in physical activity compared to women [17]. This suggests that gender differences in lifestyle factors could contribute to the increased prevalence of Alzheimer’s disease in the current female population.

Alzheimer’s Disease Prevention
While strategies to prevent, or delay the onset of Alzheimer’s disease are still under investigation, the National Institute on Aging recommends that men and women try to maintain a healthy lifestyle by:
  • Exercising
  • Eating a healthy diet
  • Engaging in social and intellectually stimulating activities
  • Maintaining healthy weight and blood pressure 
Alzheimer’s Disease Research
As we mentioned earlier, more research is needed to fully understand how and why certain people are at risk for developing Alzheimer’s disease. One way you can help is by participating in clinical research studies. The Cognitive Neurology and Alzheimer’s Disease Center at Northwestern University has several studies which are actively recruiting participants. Click here to see a list of the studies and to find out how you can get involved!  
1. Alzheimer’s Association., 2017 Alzheimer’s Disease Facts and Figures .
2. Hebert et al., Neurology . 2013; 80: 1778-83. 
3. Chene et al., Alzheimers Dement . 2015; 11(3): 310-20.
4. Farrer et al., JAMA . 1997;278:1349–1356.
5. Altman et al., Ann Neurol . 2014; 75(4): 563-73.
6. Green and Simpkins., Int J Dev Neurosci . 2000; 18(4-5): 347-58.
7. Brann et al., Steroids . 2007; 72(5): 381–405.
8. Tang et al., Lancet . 1996; 348(9025): 429-32.
9. Shao et al., Neurology . 2012; 79(18): 1846-52.
10. Shumaker et al., JAMA . 2004; 291: 2947–2958.
11. Gleason et al., PLoS Med . 2015;12(6):e1001833.
12. Stern, Y. Lancet Neurol . 2012; 11(11): 1006–1012.
13. Karp et al., Am J Epidemiol . 2004; 159(2): 175-83.
14. Farina et al., Int Psychogeriatr . 2014;26(1):9-18. 
15. Hillman et al., Nature Rev Neurosci. 2008; 9: 58-65.
16. U.S. Department of Health and Human Services, Health Resources and Services Administration, Maternal and Child Health Bureau. Women's Health USA. 2011.
17. Lin et al., Alzheimers Dement. 2015; 1(2): 103-110. 
Institute Happenings
Women's Health Science Program: Summer 2017 
 On Saturday, June 24th, the WHRI is hosting it's annual Women's Health Science Program. This year's theme is, "Reproductive Science Saturday," which will introduce young women to concepts in reproductive science and medicine through the lens of science technology, engineering, arts, and mathematics (STEAM). 

This day-long program is open to CPS high school girls in grades 9-12. Please share this information with any students you know who may be interested. The application deadline is Monday, June 5th. Applications can be found on the WHRI website. 

Upcoming Events 

June 13th: Women's Health Research Monthly Forum 
"Adolescent Life History Transitions: The Role of Family and Friends"
Dr. Kate Clancy 
Associate Professor, Department of Anthropology 
University of Illinois at Urbana-Champaign 

12:00PM - 1:00PM

Prentice Women's Hospital, 250 E. Superior Street, 3rd Floor Conference Room L South

Dr. Kathryn Clancy is an Associate Professor of Anthropology at the University of Illinois, with additional affiliations in the Program for Evolution, Ecology, and Conservation, and the Beckman Institute for Advanced Science & Technology. Clancy’s research integrates life history, evolutionary medicine, and feminist biology to contest clinical definitions of normal in women’s health. Clancy’s critical research on the culture of science has also received widespread attention. She and her colleagues have empirically demonstrated the continued problem of sexual harassment and assault in the field sciences in a 2014 paper in PLOS ONE , and astronomy and physics in upcoming publications.
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