Alzheimer’s in Women: What We Know

Globally, nearly two-thirds of people living with Alzheimer’s disease are women, and they are roughly twice as likely to develop the condition as men. While women tend to live longer than men, longevity alone doesn’t explain the stark difference. In fact, the biological and hormonal factors behind women’s higher risk are only now beginning to be understood.

One leading area of research focuses on menopause. Estrogen is a hormone that does more than support reproduction, it also helps the brain use sugar for energy. Around menopause, estrogen levels drop, and brain cells struggle to get the fuel they need. When this happens, the brain may start “burning” its own tissue for energy, which can shrink brain volume over time. This shift may lead to tissue loss and reduced brain volume, potentially setting the stage for Alzheimer’s decades before symptoms appear.

Art by Shea Davis

Brain imaging studies show that healthy middle-aged women often have lower brain energy use, less white matter (the tissue that helps brain regions communicate), and more β-amyloid plaques (a hallmark of Alzheimer’s) compared with men of the same age (Moutinho, 2025). Doctors don’t usually run these advanced scans in a routine check-up, but you can ask about early memory screenings, hormone changes, and heart health. These factors can provide important clues about brain health and long-term risk.

A Prevention-Focused Approach at Cleveland Clinic

Recognizing both the urgency and the complexity of the problem, the Women’s Alzheimer’s Movement (WAM), founded by Maria Shriver, partnered with Cleveland Clinic to create the WAM Prevention and Research Center (Cleveland Clinic). This initiative focuses on advancing sex-specific Alzheimer’s research, treatment, and education.

Drawing on studies suggesting that up to 45% of Alzheimer’s cases may be preventable through lifestyle changes, the program develops personalized prevention plans that account for a woman’s medical history, biological risks, habits, mood, and memory profile (Cleveland Clinic). By addressing factors such as diet, physical activity, and cardiovascular health, WAM aims to reduce risk before cognitive decline begins. Personalized plans often include simple but powerful changes, like eating more fruits, vegetables, whole grains, and healthy fats, staying active with regular movement, getting enough sleep, and managing stress.

The Road Ahead

Experts agree that more research focused specifically on women is critical. In 2019, only about 12% of U.S. dementia research funding went toward projects centered on women, despite their higher disease prevalence (Moutinho, 2025). Advocates argue that increasing this investment could not only improve women’s health but also ease the burden on families and the healthcare system.

Alzheimer’s is not just a disease of old age. It can begin silently in midlife. Understanding why women are disproportionately affected, and acting early to address biological risk factors, could change the trajectory for millions.

References

Moutinho, S. (2025, March 14). Women twice as likely to develop Alzheimer’s disease as men — but scientists do not know why. Nature Medicine, 31, 704–707. https://doi.org/10.1038/s41591-025-03564-3

Robertson, S. (2023, June 28). What are Amyloid Plaques? News-Medical. Retrieved August 2025, from https://www.news-medical.net/health/What-are-Amyloid-Plaques.aspx

Cleveland Clinic. Women’s Alzheimer’s Movement at Cleveland Clinic. Retrieved August 2025, from https://my.clevelandclinic.org