Women not only have higher rates of Alzheimer’s disease and other dementias, but may also be more affected by some common risk factors associated with cognitive decline, new research suggests.
Scientists at the University of California, San Diego School of Medicine analyzed data from more than 17,000 middle-aged and older adults and found that certain modifiable dementia risk factors appear to have a greater impact on cognitive function in women than in men. The findings of this study were published on May 19, 2026. biology of sex differences.
“When we looked at which risk factors were most common, we found that some risk factors had a disproportionately large impact on cognition in women,” said Megan Fitzhugh, Ph.D., assistant professor of neuroscience at the University of California, San Diego School of Medicine, and lead author of the study. “This suggests that prevention efforts may be more effective if they are tailored not only to the prevalence of risk factors, but also to how strongly each factor influences cognitive function in women compared to men.”
Researchers say the findings may help explain why women account for nearly two-thirds of Alzheimer’s patients in the United States.
Women bear a greater burden of Alzheimer’s disease
Currently, nearly 7 million Americans are living with Alzheimer’s disease, the majority of whom are women. Women generally live longer than men, but scientists say longer lifespans alone do not fully explain the difference.
Researchers are studying how biological, social, and lifestyle-related factors combine to shape dementia risk differently for women and men. Many of these factors can be changed through medical and lifestyle adjustments.
In the new study, Fitzhugh and lead author Judy Pa, Ph.D., professor of neuroscience at the University of California, San Diego School of Medicine, examined 13 established dementia risk factors using information from the Health and Retirement Study, a nationally representative group of mid- to late-life adults in the United States.
Factors include educational level, hearing loss, smoking, alcohol consumption, obesity, depression, physical inactivity, hypertension, diabetes, and other cardiometabolic diseases.
Key dementia risks affect women and men differently
The analysis revealed some notable differences between women and men.
Women were more likely to report:
- Depression (17%, 9% of men)
- Physical inactivity (48% and 42%)
- Sleep problems (45% and 40%)
The average educational attainment of the women in the study was also slightly lower, which is thought to be a risk factor for later cognitive decline.
Men were more likely to:
- Hearing loss (64%, 50% of women)
- Diabetes (24% vs. 21%)
- Heavy use of alcohol (22% compared to 12%)
Hypertension was prevalent in both groups, with approximately 6 in 10 participants having high blood pressure. The average body mass index for both men and women also fell within the overweight to obese range.
Some risk factors had a stronger impact on women’s cognition
Researchers found that some risk factors were more strongly associated with cognitive decline in women than in men.
Conditions related to heart and metabolic health, such as high blood pressure and elevated BMI, showed stronger negative associations with cognition in women. Despite being more common in men, hearing loss and diabetes were also associated with lower cognitive scores in women.
The findings suggest that the same dementia risk factors do not affect everyone equally. Health problems that cause only moderate cognitive effects in men can have a much stronger impact on women’s brain health.
“These differences highlight the importance of considering gender as a key variable in dementia research, which is largely overlooked among leading causes of death such as Alzheimer’s disease, heart disease, and cancer,” Pa said.
Towards more individualized dementia prevention
The results support the growing interest in precision medicine, an approach that aims to tailor prevention and treatment strategies to individual characteristics, including gender.
Rather than focusing solely on the most common dementia risk factors in the population as a whole, researchers suggest that it may be more effective to prioritize risk factors that appear to have the greatest cognitive impact within specific groups.
The research team emphasized that many of the risk factors identified in the study are modifiable and there may be opportunities to reduce risk through targeted interventions.
For women, this may include paying more attention to managing depression, increasing physical activity, and improving cardiovascular health, especially untreated high blood pressure.
Researchers call for more research
Researchers say more research is needed to understand why dementia risk factors affect women differently. Possible explanations include hormonal influences, genetic differences, and unequal access to healthcare, but the exact interactions remain unclear.
“Ultimately, a more nuanced understanding of these differences may help us design smarter, more targeted interventions,” Fitzhugh said. “This is an important step towards reducing the burden of dementia for everyone, but especially women, who are disproportionately affected.”
The study, entitled “Gender differences in modifiable risk factors for dementia and their association with cognition,” was funded by the National Institute on Aging (RF1AG088811, Principal Investigator: Pa) and the Alzheimer’s Association (SAGA23-1141238, Principal Investigator: Pa).
The authors reported no conflicts of interest.
