New Canadian Dementia Research Investigates the Sex-Gender Divide

by Women's Brain Health Initiative:It is a devastating omission that may have undercut years of work by brilliant researchers from around the world. Millions of dollars and countless hours have been spent investigating dementia. But in the view of Dr. Mary Tierney, if those research projects did not consider the differences between men and women, then those projects are “incomplete.”Dr. Tierney, a professor in the Department of Family and Community Medicine at University of Toronto, studies the neuropsychological aspects of dementia, including sex differences, early identification, and differential diagnosis, with the goal of improving care and treatment of older individuals with dementia. She is also a clinical neuropsychologist and director of the Primary Care Research Unit at Sunnybrook Health Sciences Centre in Toronto and leads the Women, Gender, Sex and Dementia Cross-Cutting Program of the Canadian Consortium on Neurodegeneration in Aging (CCNA). The CCNA is a Canada-wide project involving more than 350 researchers and clinicians divided into 20 teams across the country based on their area of specialization. Collectively, they are striving to accelerate research and increase understanding of age-related neurodegenerative diseases such as Alzheimer’s disease.Dr. Tierney’s role is to ensure that these researchers and clinicians keep in mind that there may be differences in how dementia affects men and women and therefore sex differences in the optimal treatments. Although it has been established that far more women develop Alzheimer’s disease than men, many research projects have neglected to explore the reasons for this difference. Additionally, despite the greater prevalence of the disease amongst women, male rats have been used almost exclusively in animal studies of Alzheimer’s disease.“It’s not true science if you’re missing 50% of the population,” Dr. Tierney said in an interview with Mind Over Matter®."If you don’t look at sex differences, you might be looking at an average, which may be false if it misses important differences between men and women.”She further noted that there was a similar flaw in the development of antidepressants and now we are observing that men and women respond differently to certain medications. Similar criticisms have been made recently in the United States and today researchers are being compelled to consider the sex of lab rats in designing their studies. Applicants for major health research grants in both the United States and Canada must explain how they are examining sex differences.Dr. Tierney says that some researchers claim it is simply a cost issue — male rodents are cheaper than females. Many scientists, though, have questioned this argument and Dr. Tierney does not accept it: “If it’s not good science, why do it?”CCNA was funded in 2014 in a joint effort by the Canadian Government, the Alzheimer’s Society of Canada, and Women’s Brain Health Initiative, together with a number of other partners, and is currently in the process of collecting human data. Dr. Tierney is working hard to ensure that the projects do not repeat the mistakes of the past. As a member of the research executive committee, she helps develop guidelines and principles for the design of studies and how to report data. Dr. Tierney says that her team has dedicated a significant amount of time to planning and implementing protocols that will ensure that both sexes are represented properly, including the appropriate use of animals in research studies.All scientists who publish data through the CCNA must first submit their articles through the publication committees. Dr. Tierney and her colleagues review the articles to ensure that they have considered sex and gender and provide the authors with feedback. If sex and gender are omitted from the research, the publication committees request an explanation.“Some say why should we care? But if we find that brain changes are different in men and women, then this might lead to better understandings of treatment,” Dr. Tierney explained.This way of thinking cuts both ways across the sex/gender divide. Dr. Tierney points out that men tend to suffer from Parkinson’s disease at a higher rate than women. Some suggested explanations for this disparity are the protective effect of estrogen in women, the higher rate of minor head trauma in men, and exposure to occupational toxins in men. Indeed, it is crucial for scientists to explore sex and gender differences.Importantly, this new way of approaching research is beginning to gain traction. “People are starting to think about it. But we need to encourage them and provide incentives for this work,” Dr. Tierney said.“And now they’re saying: this is amazing. That’s a whole area of science that has been opened.”Source: MIND OVER MATTER V6