“Women are more likely than men to have the mutated gene (APOE4) associated with Alzheimer’s disease.”

—Melissa Batchelor, PhD, RN, FNP, FGSA, FAAN

Alzheimer’s disease is a complex neurodegenerative condition with various risk factors. Women face a higher risk due to multiple contributing factors. In this episode, we explore some of the reasons that women may have a higher risk for developing dementia in their lifetime.


Alzheimer’s disease is a condition that presents a distinct challenge for women. In fact, approximately two-thirds of those diagnosed with Alzheimer’s are female. One question scientists still have is how menopause might affect cognitive decline.


Age is the biggest risk factor for Alzheimer’s disease and women tend to outlive men. In 2020, 4.2 million women are living with dementia, compared to 2.7 million men. To keep things in perspective, this means that of all adults over the age of 65, dementia only affects 11% of women and 9% of men. Scientists are still not sure why women are more affected but age, biological factors, and social influences all play a role in this complex issue.


Understanding Alzheimer’s risk in women is believed to be closely tied to the hormonal changes during menopause. Perimenopause, which typically starts between ages 45 to 55 and can last 7 to 14 years, and marks the transition to menopause. During this time, the ovaries produce less estrogen and progesterone, hormones that help protect the brain. The decrease in these hormones aligns with a potential decline in cognitive function and a higher risk of Alzheimer’s.


Estrogen therapy is believed to reduce dementia risk during early menopause, but it’s important to work with your provider to determine if the risks outweigh the benefits.

The FDA advises against using hormone therapy in women over 65 and women already diagnosed with dementia due to possible worsening of cognitive symptoms. More research is needed to understand how hormone therapy affects brain health, and if there are safer treatments such as bioidentical estrogen (compared to synthetic estrogen) personalized to the individual person.


While we wait for more evidence about the impact of menopause on brain health, it’s important to take a comprehensive preventive approach. This includes making lifestyle changes like getting enough sleep, eating well, exercising regularly, and managing stress to reduce Alzheimer’s risk factors. It’s also crucial to stay socially connected, keep mentally active, and have regular medical check-ups as part of a holistic preventive strategy.


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About Melissa:

Melissa Batchelor, PhD, RN, FNP, FGSA, FAAN. I am a nurse, nurse practitioner, nurse educator and nurse researcher with over 25 years of experience in the aging and long-term care healthcare space. You can visit my website at MelissaBPhD.com to learn more about me, how you can work with me directly,
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