Does Sex Matter?

By Women's Brain Health Initiative:“Profoundly!” according to Dr. Pauline Maki.Sex and gender definitely matter as we age. “ Women with the strongest risk factor genetically for Alzheimer’s Disease have a 50% increased risk of AD compared to the man next to her who has that same gene,” said Maki.Sadly, there remain huge gaps in our knowledge of why these differences exist. This is, in part, because clinical studies in some areas still tend to focus on men only. Also, there is still little research being done on how important social determinants of health affect older women and men differently. And finally, researchers often simply ignore older people in general when gathering data. For these reasons and others, aging women’s health is still emerging as an area of knowledge.Uppermost in this thirst for knowledge is the quest to understand why so many of us are having trouble recalling names, book titles, appointments, and why we are struggling with midlife mental lapses.According to Dr. Maki, we don’t know why women are more vulnerable to memory loss, but the neuroscience community has some very good hints.Estrogen is responsible for a lot more bodily functions than we generally give it credit for, and its slow withdrawal from the body has a set of side effects, among them a potential contributor to worsening memory. The Study of Women’s Health Across the Nation (SWAN) measured cognitive performance during menopause transition.  The SWAN study assessed verbal/episodic memory, logical memory and working memory.  The study found the decline in memory during menopause is a sign of abnormal cognitive function and not aging because improved memory returned after menopause.A 2008 study at the University of Illinois found a link between hot flushes and poor verbal memory. The study followed other research that found about 40 per cent of women report becoming more forgetful around menopause.  “The more hot flushes a woman had, the worse her memory performance,” says Dr. Maki. Maki found women whose hot flushes disturbed their sleep suffered even worse memory problems.Researchers have also found that too much stress over a prolonged period interferes with the normal processes in storing everyday memories.  “Previous studies have found that females are more resilient to chronic stress and now our research has found the reason why.” Says Zhen Yan PhD., a professor in the Department of Physiology and Biophysics in the University at Buffalo School of Medicine and Biomedical Sciences.  The research shows that in rats exposed to repeated episodes of stress, females respond better than males because of the protective effect of estrogen."When estrogen signaling in the brains of females was blocked, stress exhibited detrimental effects on them," explains Yan. "When estrogen signaling was activated in males, the detrimental effects of stress were blocked.  "We still found the protective effect of estrogen in female rats whose ovaries were removed," says Yan. "It suggests that it might be estrogen produced in the brain that protects against the detrimental effects of stress."In another study, researcher Alexandra Ycaza of the University of Southern California found women with the highest estrogen levels performed well on recall tests while being subjected to varying levels of stress while in contrast, women with the lowest estrogen levels performed worse.The findings suggest that estrogen provides a natural buffer against the negative impact of stress on short-term memory in women, Ycaza said.“However, it’s not all bad news,” says Maki.   “We can control the negative affect of memory through stress reduction.  Through yoga, exercise, and various practices of mindfulness – meditation techniques such as focused breathing and body awareness.“Dr. Pauline Maki says menopausal women tend to be much better than older people at recognizing and assessing their memory deficits."It may be that women are generally more tuned in to bodily changes because so many changes are happening all at once," she said.