Why Alzheimer’s Disease Disproportionately Affects Women+ — And What Midlife Can Do.
Understanding the imbalance
Globally, more than two-thirds of people living with Alzheimer’s disease (AD) are women+. Though longer life expectancy plays a role, it’s not the whole story. Emerging research suggests that being a woman+ is itself a risk factor for Alzheimer’s, driven by hormonal shifts, vascular changes, immune-inflammation, and social circumstances.
It’s not just ageing — midlife matters.
Hormones, menopause and brain vulnerability
One of the strongest signals pointing to women+ risk is the connection between menopause (and consequent oestrogen decline) and the brain’s health. Research shows that earlier menopause is associated with significantly higher dementia risk. For example, women who undergo menopause before age 40 have a ~1.47-fold increased risk of dementia compared with those whose menopause occurs around 50-52 years.
Mechanistically, oestrogen supports brain metabolism, synaptic plasticity and neuronal connectivity — all essential for cognitive resilience. When these protective effects reduce, brain ageing may accelerate. Added to this is the fact that the menopausal transition is marked by systemic and central nervous system inflammation, which may further reduce brain resilience.
Vascular, immune & lifestyle intersections
Women+ also face unique vascular and immune factors:
Cardiovascular disease, hypertension and metabolic dysregulation are known dementia risk factors — and midlife women+ often experience changes in these areas after menopause.
Autoimmune diseases are more prevalent in women+, and chronic inflammation from such conditions is increasingly viewed in dementia research.
Lifestyle and social determinants matter: decades of roles, stress, sleep disturbances, caregiving burdens and less research targeted to women+ brain health all contribute.
Is Alzheimer’s showing up younger?
While Alzheimer’s is typically associated with older age, recent studies suggest some markers and risk trajectories begin much earlier in life — particularly for women+. Changes in metabolic health, sleep disturbance, hormonal transition and midlife stress may set the stage for later risk. A sweeping international study found dementia to be approx. 46% more common in women than men across nearly 1 million people in 43 countries — further suggesting sex-based vulnerability beyond age alone.
What women+ can do now — midlife as prevention
The good news: though genetics and age are unchangeable, many of the brain’s risk and resilience mechanisms are modifiable. For women+, focusing on midlife health is especially powerful. Here are key strategies:
Hormone-aware care: Discuss menopausal timing, hormone replacement options, sleep health and brain-supporting strategies with your practitioner.
Cardiovascular & metabolic health: Keep blood pressure, glucose, lipids and waist-circumference in check.
Sleep and stress regulation: Prioritise quality sleep, manage chronic stress, reduce night-sweats, optimise circadian rhythm.
Nutrition and movement: Emphasise whole foods, anti-inflammatory diet, omega-3 fatty acids, and regular aerobic and resistance exercise.
Cognitive and social engagement: Stay mentally active, socially connected and intellectually stimulated — data shows this reduces risk across genders.
Early screening & monitoring: If menopause is very early or you have strong family history, ask about brain health baseline screening and plan proactively.
Why this matters
For too long, women+ brain health has been overlooked. The disproportionate burden of Alzheimer’s among women+ isn’t simply because of ageing — it reflects structural, hormonal and lifestyle‐based vulnerabilities.
At Elgin House, we believe midlife is the moment for empowerment. By supporting women+ with tailored, whole-body care — from hormones to heart, sleep to cognition — we can shift the trajectory of brain-health outcomes.
Your brain deserves as much care as your hormones, your skin, your gut and your heart. The choices you make today lay groundwork for decades ahead.
Reference Research & Further Reading
Moutinho S. Women twice as likely to develop Alzheimer’s disease as men — but scientists do not know why. Nature Medicine. 2025;31:704-707. nature.com
Silva GB, et al. Influence of the Onset of Menopause on the Risk of Alzheimer’s disease. PMC Journal. 2024. PubMed Central
Scheyer O, et al. Female Sex and Alzheimer’s Risk: The Menopause Transition. ScienceDirect. 2018. ScienceDirect
Dobson AJ, et al. Menopause age and type and dementia risk. Ageing. 2024;53(11):afae254. OUP Academic
Gong J, et al. Sex differences in dementia risk and risk factors. Alzheimer’s & Dementia. 2023. Alzheimer's Journals
McCarthy M. The peri-menopause in a woman’s life: a systemic inflammatory event. Journal of Neuroinflammation. 2020;17:121. BioMed Central