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According to a Swiss neuroscientist, the diagnosis of Alzheimer’s disease is poorly made or made later in women. The reason ? They would be taken less seriously than men.
Whether in terms of prevention, diagnosis or care, women are often less well cared for than men, because of a less good knowledge or consideration of their pathologies, their symptoms… fact is now established for cardiovascular diseases or the delays in diagnosis specific to certain female diseases (endometriosis, vestibulitis, etc.). But until then, these inequalities had not been mentioned for neurological diseases. But today, Antonella Santuccione Chadha, a neuroscientist specializing in Alzheimer’s, says in an interview on Heidi News, that there is a real difference in the diagnosis of this disease. The scientist published an essay on the subject in 2021: Sex and Gender Differences in Alzheimer’s Disease.
Women more affected by Alzheimer’s than men
Two-thirds of people with Alzheimer’s disease are women, and it’s not just age-related. It is not because the life expectancy of women is longer that they develop more pathologies linked to old age, according to the Swiss scientist:
“Age is indeed a specific factor for Alzheimer’s disease. However, when we observe the number of people who have developed the pathology at a given age, for example at 70, we realize that, systematically, the majority of cases are women. The mere fact that we live a few more years does not therefore justify this higher number”.
But then, how to explain this predominance among women? Here again, the expert lists a few possible elements:
- Hormonal changes associated with menopause, with the decrease in estrogen levels, could increase the risk of developing dementia;
- Poor sleep quality also weighs on cognitive decline. However, sleep problems are frequent during pregnancy, when children are young, and during menopause;
- Several studies also talk about the level of education, and the continuity of lifelong learning as preventive factors for dementia. However, among older generations, studies have often been shorter for women than for men.
Patients diagnosed less well, or too late
Despite this inequality in the face of the disease, the neuroscientist remarks during her work that women are nevertheless diagnosed later. The fault of good linguistic abilities which often allow women to hide their disorders longer and thus to deceive the current diagnosis, but not only:
“On the other hand, patients who present with the first signs of cognitive decline are not always taken seriously by their doctors, and are told that their symptoms are related to stress or depression. Unfortunately, this is a common bias in medicine that leads to misdiagnoses. A doctor who sees a 60-year-old patient suddenly showing signs of depression should always ask whether there are cases of Alzheimer’s in the family, what the risk factors are and clarify the situation if necessary. ”
Especially since, for those who know the subject, depression is one of the first symptoms of the early phase of the disease. It is therefore to be considered seriously, and not as a feminine trait.
“There is still too much of a tendency to “psychologize” women”
For Maud Le Rest, co-author with Eva Trapiero of The Patients of Hippocrates, when medicine mistreats women(Editions Philippe Rey, 2022), the mechanism is still prevalent in many medical fields, in particular psy, and can indeed cause delays in diagnosis.
“There is above all something in the order of the education of women which persists from an early age: they are generally taught to blend in better with society and to complain less. They often go under the radar for longer” she reveals.
Paradoxically, while they are educated to contain themselves, medicine generally perceives women as very emotional, which is also a concern.
“There is still a lot of presumption of hysteria in women, we imagine that they are overdoing it, which can sometimes be dramatic: in heart attacks, for example, women are treated on average 30 minutes later than men, because it is easier to imagine that they are having an anxiety attack” .
As for the depression or stress factor evoked instead of an Alzheimer’s diagnosis, the author notes another paradox, which may explain the delay:
“The stress evoked is a snake biting its own tail. Women are more stressed, because their life is generally more stressful (violence, mental load, etc.). In addition, they are prescribed more anxiolytics, but simply because they consult more. Consequently, we tend to “psychologize” them very quickly. We imagine that women need more psychological support and not medical solutions, which delays their treatment.” regret the journalist.
A situation that should gradually change, because doctors today benefit from training that includes these gender issues. An evolution that is going in the right direction but in the long term… unless a collective awareness comes more quickly to sweep away these clichés.