Women and dementia

[ArabellaScott]

A fascinating and carefully written article here, on how dementia affects women, written by a geriatrician and internal medicine physician. The author considers both biological sex and socialised gender roles (and is clear as possible on the difference between these things).

'though there are no differences in intellectual capacity, for so many of my patients, from childhood onwards, their social role has been defined by gender, from educational opportunities to work, childbearing and the authority within their own household. These things and many more all influence the development of dementia and the way that dementia is diagnosed.'

So many fascinating things in here from:

'Oestrogen helps women prepare for motherhood: during pregnancy, women’s brains become more plastic and more able to learn'

to:

'Some women do experience a decline in memory and processing speed during the time of menopause, but these changes resolve once the hormonal changes have settled'

As well as thoughts on cultural influences and context and how these impact on diagnosis and progression.

I think every woman should read it.

aeon.co/essays/how-the-life-paths-of-men-and-women-affect-the-diagnosis-of-dementia

Thanks, that's a really good and interesting piece.

Thank you that's fascinating.

Lisa Mosconi has been researching this too; and does believe that oestrogen levels during mid life is a risk factor, plus other factors. Eg ability exercise. She does point out that the time at which it would have the most beneficial protective effect is often the time when women are often most stretched due to gender roles. (Though adds that little / often is key rather than long and heavy).

thedoctorskitchen.com/womens-health/the-doctors-kitchen-podcast-59-how-to-reverse-ageing-part-3-of-4-the-female-ageing-brain-with-dr-lisa-mosconi

Oh, great stuff, Warrior, thank you. I had seen some articles from Lisa Mosconi, recently, I think.

And Errol, yes, I appreciated the nuance and thought that had gone into the essay. It's a little bit depressing that as for so many things, the ultimate conclusion is that more research is needed. This research needs to be starting, now! So we have data for the long term.

That was fascinating. I'm going to be pondering some of the questions raised in the article all day! I'll think and come back 😊

Glad you enjoyed, Iamhanging. I've just ordered Dr Mosconi's XX Brain book.

It's so hard to unpick all the factors. I wonder what effect the decades of retirement age being different for men and women in the U.K. was - good for some health issues, bad for others I'd guess. Somewhat tangentially it occurs to me that the later retirement ages now may have some benefits especially for women in public life and management roles. I'm not in those myself but I do seem at 60 to have something of a 'second wind' work wise after the doldrums in much of my 50s , just at the point in my mother's generation I'd be pensioned off.

That podcast sounds really interesting, I'll have a listen later.

Yes, there are so many intertwining and possibly interacting factors, Errol, it's a very complex subject, by the look of it. But increasingly more important, sadly.

I do notice a lot of 60 yo's seem to get a sudden burst of energy in terms of work - maybe some other pressures have eased off by then and leave space/time for more meaningful work?

Thanks, that was a very interesting read.

I do notice a lot of 60 yo's seem to get a sudden burst of energy in terms of work - maybe some other pressures have eased off by then and leave space/time for more meaningful work?

It's partly that I'm sure, but personally I do feel more like there's been some sort of internal reset. If it was pressures/time, then the step change was DD going to uni - she's in her 4th year now. I'm probably straying into a whole other discussion on meno/post meno effects.

Women at 60 is an interesting subject for discussion. So many variations possibe.

I had my children in my very early 30s. They're now in their late 20s. No grandchildren. My parents are still alive and living independently, in reasonably good health and with no signs yet of cognitive decline. My husband is retired and in good health. I don't expect to be working much longer (part-time for the last few years). All of this has probably made the menopause much more manageable for me than for many other women, with far more on their plate than I have.

It remains to be seen whether the lack of work affects my brain. Need to ensure I have some worthwhile and taxing things to do. My parents threw themselves into all sorts of voluntary work and joined a choir and various societies when they re-located shortly after my Dad retired. Seems to have paid off.

That is an excellent piece and it's going to repay careful rereading.

I know that the online world is affecting my memory - and I should think the same will be true for others. I have distinct memories of some items but as they undergo cyber rot or disappear from public records for GDPR or because someone has actively removed them then it becomes harder to use that memory with others. Mostly because others expect to be able to 'verify' something online and we haven't yet reached the stage where there is wide acceptance that 'online' isn't the omniscient archive it's thought to be and can be an unreliable narrator/historian.

Like many other women, in addition to the work that I do, I have caring responsibilities for people whose memory and cognition are poor and can be subject to delusions and behave chaotically. The past year has created a coming together of so many factors that I do, at times, feel as if my brain is leaking from my ears and eyes. I consciously have to stop multi-tasking because I feel the strain of it.

I should think I'm not alone in any of the above - and I wonder how this can be factored into diagnostic assessments, MMSEs etc.

Embarrassing, there was a really interesting piece on how the pandemic has affected memory in ... I htink it was New Scientist. Basically saying all our usual routines/habits that we usually save mental bandwidth by carrying out nearly unconsciously (they reckoned about 40% of daily life) were now having to be rethought and so another drain on working memory.

Also

Can't find the NS article.

www.psychologytoday.com/us/blog/evidence-based-living/202009/the-pandemic-may-be-affecting-your-memory

www.newscientist.com/article/mg25033300-400-how-to-keep-your-brain-healthy-the-7-things-you-should-do-every-day/

Lockdown has had devastating effects on cognition and memory -

www.alzheimers.org.uk/news/2020-07-30/lockdown-isolation-causes-shocking-levels-decline-people-dementia-who-are-rapidly

Fascinating thread!

A very interesting read and only time will tell. My poor mum has Alzheimer’s, it’s a disease I would not wish on anyone. As a woman in her late 40’s, probably in perimenopause and having been a SAHP for many years I find this interesting and frankly a little terrifying that I may be heading towards the same path as we have both lived similar lives so far.

The Lisa Mosconi podcast is interesting when it gets to different reactions to stress and oxytocin. Apparently 35 - 40 is an important time.

"Some women do experience a decline in memory and processing speed during the time of menopause, but these changes resolve once the hormonal changes have settled"

That is not what scientific studies say

Women are at significantly higher risk for dementia & Alzheimer than men, and this sex-specific risk decreases in proportion to years of HRT at menopause until about 10 years IIRC.

I'm sorry about your mum, Ima. That must be very hard.

Thanks for the link, Cote. That's interesting. I'm wary about mucking with my hormones after disasterous times on the pill. I wonder if there are other ways to address the decline in oestrogen? A book on menopause suggests a high protein diet (and reducing stress, though I find that advice somehwat laughably impossible, sometimes) can help with the interactions between hormones and cortisol etc.

Addressing adrenal issues with lifestyle, low sugar diet, etc, seems like a good thing.

www.amazon.co.uk/Happy-Menopause-Nutritional-Choices-Flourish/dp/178678372X?tag=mumsnetforu03-21

@ErrolTheDragon

It's so hard to unpick all the factors. I wonder what effect the decades of retirement age being different for men and women in the U.K. was - good for some health issues, bad for others I'd guess. Somewhat tangentially it occurs to me that the later retirement ages now may have some benefits especially for women in public life and management roles. I'm not in those myself but I do seem at 60 to have something of a 'second wind' work wise after the doldrums in much of my 50s , just at the point in my mother's generation I'd be pensioned off.

Yes, that's an interesting point. It could also be good for women who have kids earlier and want to begin a career a little later, which I think has a lot to recommend it as a model.

Maybe, but try telling that to my 20-something self, SmokedDuck!

Thank you Arabella for the link to the essay and thank you for other link Warrior.

I had no idea that oestrogen was a protective factor against ageing and that when we hit menopause women's ageing is accelerated and overtakes men's. I also had no idea that women were more likely to suffer from Alzheimer's than men. In fact, there were lots of facts and figures in the podcast about women's health and how their physiology impacts on their health differently to men eg strokes, depression etc. I haven't finished the podcast so I'm sure I will learn more.

The essay was thoughtful and, somewhat introspective. One of the things I wanted to highlight was how some women carry on denying that their husbands etc have dementia. The author thinks that it's because they might see it as being emasculating. My MIL found it hard to admit that FIL was deteriorating because it was admitting that he was unwell and becoming less of himself. It must be devastating to see your life partner losing themselves.

I have other points as well but I shall leave it there for now. I think this is the longest post I have ever written! Thank you again.

Yes, I think there's much more to sex difference than I'd realised. What I thought was especially interesting was the interplay between underlying sex difference and gender roles.

'Gender' can be a really useful concept, finding it especially annoying that it's become totally subsumed into this vague, blurry catch-all category that sometimes is used to mean sex and sometimes stereotypes. It's important and necessary that we can differentiate clearly between sex and gender, this becomes ever more evident.