More and more American families must address the consequences of aging and the long-term care needs that come from an extended illness, accident, or other issues of aging – including cognitive decline. This puts a financial, emotional, and physical burdens on family members who usually must either provide care or manage paid care services.
Research shows nearly two-thirds of Americans with Alzheimer's disease are women. Now researchers questions to long-held belief it is merely due to the fact that women have more longevity than men.
Questions Being Asked
Several questions are being asked. What other factors make a woman have a more significant risk for cognitive decline? Are genetics part of the equation? Are biological differences in how women age compared to men? Could certain lifestyle factors cause a high risk of women suffering from cognitive decline?
The fact is this risk is a real concern.
According to the Alzheimer's Association, there is a clear increased risk based on gender. By the time a woman reaches age 65, the risk of suffering from Alzheimer's is 1 in 6. What many people are unaware of is the risk of a woman developing Alzheimer's is double their risk of breast cancer. The association says Alzheimer's disease is the 6th leading cause of death in the United States. Alzheimer's is the only cause of death in the top 10 that cannot be prevented, cured, or even slowed.
Cognitive Decline Means Long-Term Care
However, death is only a part, although the final part of the impact of Alzheimer's. The need for supervision and other help with routine activities of daily living is a tremendous burden on family and finances. Health insurance, including Medicareand Medicaresupplements, will not pay for this care.
But there is more. Women get hit twice because of this disease. They often become caregivers for a husband or other family member who requires long-term care. Interestingly enough, women are more likely to care for others with Alzheimer's as well. So not only are women more likely to suffer from cognitive problems, they typically become the first caregivers.
Women Also Caregivers
The Alzheimer's Association says more than 3 in 5 unpaid Alzheimer's caregivers are women — and there are 2.5 more women than men who provide 24-hour care for someone with Alzheimer's. In 2016, more than 15 million caregivers of people with Alzheimer's or other dementias provided an estimated 18.2 billion hours of unpaid care, a contribution to the nation valued at $230.1 billion.
Because of the stress, burden, and time of their caregiving duties, women are likely to experience adverse consequences at work. Approximately 19 percent of women Alzheimer's caregivers had to quit their job either to become a caregiver or because their caregiving duties became too burdensome. This has a tremendous impact on the caregiver's family financially. Plus, there is an emotional toll on the caregiver's family relationships.
In the end, almost 500,000 people every year die with Alzheimer's.
Discovering the answers as to why women suffer from more cognitive decline than men could affect available treatments or even preventive care. One hint is the research is showing that an Alzheimer's related gene has a more significant impact on women than men. However, genetic factors are considered only part of the problem.
"There are enough biological questions pointing to increased risk in women that we need to delve into that and find out why."Maria Carrillo, chief science officer for the Alzheimer's Association.
The Alzheimer's Association had brought 15 leading scientists together to ask what's known about women's risk. Research is being conducted to find answers.
There is a lot that is not understood and not known. It's time we did something about it," she added.
"It is true that age is the greatest risk factor for developing Alzheimer's disease."Roberta Diaz Brinton, University of Southern California professor
The World Health Organization had presented data on gender differences at a meeting of the National Institutes of Health.
"on average, women live four or five years longer than men, and we know that Alzheimer's is a disease that starts 20 years before the diagnosis."Roberta Diaz Brinton
That's how early cellular damage can quietly begin. Brinton is researching if menopause can be a tipping point that leaves certain women vulnerable.
There's some evidence that once Alzheimer's becomes diagnosed, women may worsen faster; scans show more rapid shrinkage of specific brain areas.
But gene research offers the most startling evidence of a sex difference.
Stanford University researchers analyzed records of more than 8,000 people for a form of a gene named ApoE-4, long known to increase Alzheimer's risk.
Women who carry a copy of that gene variant were about twice as likely to develop Alzheimer's eventually as women without the gene, while men's risk was only slightly increased, according to Stanford's Dr. Michael Greicius.
It's not clear why. It may be in how the gene interacts with estrogen, Brinton said.
Amy Shives, 57, of Spokane, Washington, in a Yahoo News story recalled when her mother began showing symptoms of Alzheimer's. She says it wasn't until after her own diagnosis a few years ago that she looked up the gender statistics.
"That was alarming," said Shives, who is in the early stages of Alzheimer's, which struck at a younger-than-usual age and forced her retirement as a college counselor. "The impact on our lives and that of our families is extraordinary."
She points to another disproportionate burden that the majority of caregivers for Alzheimer's patients are women.
"My daughters are in their 20s and I'm already ill."
"It's very stressful for them to think about when their mother's going to need their help."Amy Shives, mother
What drives the difference in Alzheimer's cases isn't clear, said Dr. Susan Resnick of the National Institutes of Health, pointing to conflicting research.
"We really have had a tough time understanding whether or not women really are more affected by the disease, or it's just that they live longer."Dr. Susan Resnick of the National Institutes of Health
Data from the long-running Framingham, Massachusetts, health study suggests that because more men die from heart disease in middle age, those who survive past 65 may have healthier hearts that, in turn, may provide some brain protection.
Many of the same factors — obesity, high cholesterol, diabetes — that damage arteries also are Alzheimer's risks.
One question being asked is the role of hormones? That's has been hard for researchers to answer so far. Many years ago, a major study found that estrogen therapy after age 65 could increase the risk of dementia. However, later research showed hormone replacement around the onset of menopause did not pose an issue.
Brinton studies how menopause changes the brain. Estrogen helps regulate the brain's metabolism, how it produces the energy for proper cognitive function, and it must switch to a less efficient backup method as estrogen plummets, she explained.
"It's like the brain is a little bit diabetic."Roberta Diaz Brinton
The question is whether this higher risk may relate to menopausal symptoms in women who later experience cognitive problems.
Carrillo notes that 40 years ago, heart disease was studied mainly in men, with little understanding of how women's heart risks can differ.
"How do we make sure we're not making that mistake when it comes to Alzheimer's?"Maria Carrillo
All this research doesn't change the world we live in today and what we do with this knowledge. Unfortunately, despite many news stories about the risks of cognitive decline and long-term care, many people are unprepared for the physical, emotional, and financial burdens that American families face when a loved one requires long-term care services.
Preparing Your Family and Finances
The natural human reaction for many people is it won't happen to them, or they will deal with it when the time comes. The best way to address the financial costs and burdens of aging is with advance planning.
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The best time to plan is in your 40s or 50s when premiums are low, and your health is still good. Don't wait until you have few or no options available.
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portions of this article were originally published on YAHOO NEWS -
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