Wellness
Women have a far higher risk of dementia – and urgent action is needed
Recently published research has turned an overdue spotlight on the disproportionate burden of dementia borne by women. It is encouraging to see this research progressing, and inspiring to see it stimulating public awareness and discussion of a disparity that has too long been overlooked: women are twice as likely as men to develop Alzheimer’s disease.
By Andrea Pfeifer
We have been searching for new treatments for Alzheimer’s disease for decades and are now able to offer patients medicines that can slow the rate of memory loss. The research that led to the approval of these effective new medicines created a tremendous bank of knowledge about how Alzheimer’s causes damage to the brain – knowledge that enables us now, for the first time, to work on strategies to prevent damage before it happens.
As much as we have learned, however, we still do not understand why women are more prone to developing dementia and Alzheimer’s than men, nor do we know whether or how approaches to diagnosis, treatment and prevention should differ based on sex.
Researchers around the world are urgently studying questions about what causes these differences, and what they mean for treatment and prevention. In addition, new and exciting research is investigating sex-based differences in the effects of lifestyle and environmental factors that could lead to precision prevention approaches tailored for women and for men.
For this research to continue, its crucial to support public health strategies – and for us to continue to talk about dementia risk with the women in our lives to raise awareness of the ways we already have to preserve brain health.
Factors at play
Worldwide, about two-thirds of people living with Alzheimer’s are women. Women face a disproportionate burden in terms of care and lost economic productivity, and this is true across high-, middle- and lower-income countries.
Multiple reasons have been suggested to explain this difference. Among the hypotheses are higher life expectancy in women, because age is a risk factor for Alzheimer’s, and lower education in women, because limited education also is a risk factor. Geographical differences have been found, and we also know that one of the genetic factors that increases the risk of Alzheimer’s, a gene variant called APOE e4, has a stronger effect in women.
Women who carry APOE e4 are more likely than male carriers to accumulate toxic proteins in the brain, called amyloid plaques and tau tangles, which drive the loss of memory and cognition in Alzheimer’s. In addition, women who have amyloid and tau accumulation have faster disease progression rates compared with men.
Hormonal changes, particularly the decline in oestrogen during menopause, also may contribute to increased Alzheimer’s risk in women. But all women experience menopause, and not all women develop Alzheimer’s, so researchers are still working to understand how and why changes in hormones affect Alzheimer’s risk.
A study recently published in Science Advances by a team at Massachusetts General Hospital led by Dr. Gillian Coughlan investigated associations between hormone therapy and tau accumulation in menopausal women. The results further support a role for hormones in Alzheimer’s, and also highlighted a highly complex relationship between hormones and other factors such as age that need continued study.
Environmental and lifestyle factors also play a role in Alzheimer’s risk, and we are just beginning to study whether there are sex-based differences here as well.
All of these factors need more study, and understanding how they combine to affect risk for women as a group and for men and women as individuals will take time. Fortunately, there is a clear path forward.
Charting a way forward
The balance between women and men in clinical trials for Alzheimer’s treatments, which have historically underrepresented women, have improved in recent years. Yet detailed analyses of sex-specific differences in these studies are still lacking.
For example, trials of both the new Alzheimer’s medicines showed some difference in treatment results for women vs. men. However, neither trial was designed to draw conclusions about how important or meaningful those differences are, or to understand whether such differences could be related to other factors such as hormone profiles, education, and so on.
Going forward, we need to ensure that the participation of women and men in clinical trials reflects the prevalence of Alzheimer’s in both sexes. There is a need for sex-based data collection and analysis across all stages of research, from basic biology research to clinical trials.
One way to ensure this is to make the integration of sex and gender in research plans a requirement for funding or publishing. Another is to enhance diversity in teams in research, policy, and healthcare practice.
We also need to redouble our efforts to reduce dementia risk globally, and to increase awareness of the tools that we already know can make a difference.
My goal, as the CEO of a biotech working in Alzheimer’s disease and the co-founder and Chair of the Global BHP Braintrust, is to develop and promote effective strategies to reduce the overall risk of dementia using a Precision Prevention approach that includes active immunotherapy and lifestyle changes.
Active immunotherapy is a type of medicine that stimulates the immune system to clear or prevent the accumulation of pathological proteins like amyloid or tau. These medicines are still in development but could be available in as little as five years.
Lifestyle interventions enable everyone to target modifiable risk factors such as diet, exercise, cognitive and social stimulation, and vascular health.
It is estimated that at least 40 per cent of cases worldwide can be linked to modifiable facets of lifestyle including cardiovascular, metabolic and environmental factors. A landmark study called the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) showed that a multi-faceted lifestyle intervention program could improve brain health and prevent cognitive decline by about 30 per cent.
The intervention combined healthy food, physical activity, mental stimulation, social activities, and cardiovascular risk monitoring.
The benefit of the intervention on cognitive outcomes did not differ significantly between men and women. Sex-specific differences in certain cognitive domains, as well as in the adoption of lifestyle changes, point to the opportunity to further improve the impact of the intervention.
The Global BHP BrainTrust is now collaborating on FINGERS Plus for Women, a research initiative to explore the potential for gender-specific interventions to further reduce the risk of dementia.
A better future
Used together, both active immunotherapy and lifestyle interventions could enable a more personalized risk reduction strategy based on an individual’s sex, genetic risk, biomarkers, and lifestyle factors.
Many of us have family or friends who suffer from dementia. We know that it is a global scourge that silently ravages millions of lives.
Together with other researchers, companies, and policymakers, we have the capacity to close the gap between women and men, addressing this pressing public health concern for all.
Prof. Andrea Pfeifer is co-Founder and CEO of AC Immune, a Swiss biopharmaceutical company pioneering precision prevention for neurodegenerative diseases. She has led the company since founding in 2003 and through an IPO and multiple partnerships with leading pharmaceutical companies. She was previously Head of Nestlé Research Centre, where she played a major role in connecting science and business.
Prof. Pfeifer is a key member of the CEOi initiative on Alzheimer’s Disease and the Davos Alzheimer’s Collaborative (DAC), a Founding Chair of the Global BHP Braintrust, and in 2021 was awarded the first SEF.WomenAward for CEO of the Year by the Swiss Economic Forum. She holds a Ph.D. in Toxicology (Cancer Research) from the University of Würzburg, Germany and is an Honorary Professor at the Ecole Polytechnique Fédérale de Lausanne (EPFL).
Women’s health startup Ovum has raised US$4m in seed funding to develop its AI health journal and expand research using women’s health data.
The round valued the Melbourne startup at US$18m.
Ovum plans to use the funding to develop its artificial intelligence technology and longitudinal datasets, which track health information over time to reveal changes and patterns.
The AI captures symptoms, lifestyle factors, biometric measurements, reproductive health stages, medication, appointments and medical reports.
It uses this information to identify health patterns and create summaries and questions for medical appointments.
Ovum previously raised US$1.7m in pre-seed funding in February 2025 before launching its health journal app in August that year.
Since then, the company says the app has grown by 30 per cent month on month and recorded more than 20,000 downloads.
It has captured 57,000 health data insights and hosted more than 107,000 AI health conversations involving women aged between 15 and 84.
Founder Dr Ariella Heffernan-Marks developed the idea while she was a third-year medical student experiencing chronic migraines and was told that her pain was caused by anxiety.
The company describes the resulting women’s health journal as combining technology and clinical research to make health information more actionable and equitable for women.
Heffernan-Marks said: “I’ve sat on both sides of the desk, as a patient and as a doctor, and that’s why this mission matters so much to me.
“For too long, women have had to navigate healthcare systems that were not designed around their lived experiences or backed by sufficient female health data. Ovum exists to help women better understand their bodies, advocate for themselves with confidence, and contribute to research that improves care for future generations.”
Private health insurer Medibank is an Ovum partner, alongside Fernwood Fitness, Sweat and Menopause Friendly Australia.
Australian Red Cross Lifeblood is also involved in a pilot examining productivity losses caused by women reducing their working hours or leaving employment for health reasons.
Earlier in 2026, Ovum launched clinical trials with St George Hospital and the Royal Hospital for Women to assess AI as a preventative health tool for women.
The research is examining how women currently manage their health, which digital tools they use and whether AI could support health confidence, self-advocacy and continuity of care.
Continuity of care means receiving connected and consistent support across different appointments, healthcare professionals and services.
The funding round was led by Admiralty Capital Group, with participation from Antler, Giant Leap, Aviron Investments, Foggy Valley Aotearoa, Brisbane Angels and Think & Grow.
Existing investor LaunchVic, which is due to merge with Breakthrough Victoria, also participated through its Alice Anderson Fund, which focuses on female founders.
Amanda Andriano, founding partner at Admiralty Capital Group, said the gender health gap was a problem that should not be tolerated.
She said: “Ovum combines mission, market timing and technical capability with an exceptional founder uniquely positioned to lead this movement, and we believe that creates the foundation for a company of global significance.”
Women who do strength training may have a lower risk of major cardiovascular disease, particularly alongside aerobic activity, a study suggests.
Cardiovascular disease is the leading cause of death worldwide. Aerobic activities such as brisk walking, jogging, cycling and swimming are already established ways to help reduce the risk.
Strength or resistance training, also known as RT, is less established as a prevention strategy. It makes muscles work against a force and can involve body weight, free weights, resistance bands or machines.
Current US guidelines recommend at least two days of strength training and 150 minutes of moderate-to-vigorous aerobic activity each week.
They also recommend limiting sedentary behaviour, including prolonged television viewing, which is considered an independent risk factor for cardiovascular disease.
Dr Tianyue Zhang, lead study author and scientist in the department of nutrition at the Harvard T.H. Chan School of Public Health, said: “Despite its established health benefits, RT is often overlooked as a prevention strategy for CVD, and its impact on CVD risk, especially in middle-aged and older women, remains understudied.
“A key question is, how much does it add beyond aerobic activity alone?”
Researchers analysed data from 117,025 women participating in the Nurses’ Health Study and Nurses’ Health Study II.
The two groups had average starting ages of 66.8 and 48.1 years respectively.
The women reported their resistance training every four years, with exercises involving the arms and legs recorded separately.
Time spent watching television was used as the main measure of sedentary behaviour.
The researchers examined exercise and television-viewing habits alongside the incidence of major cardiovascular disease.
Major cardiovascular events included fatal or non-fatal heart attacks, strokes, coronary artery bypass surgery and percutaneous coronary intervention.
Coronary artery bypass surgery redirects blood around narrowed or blocked heart arteries. Percutaneous coronary intervention uses a small balloon, often followed by a stent, to open a narrowed artery.
Higher levels of strength training were associated with a lower risk of major cardiovascular disease, particularly heart attacks.
No statistically significant link with stroke was found when resistance exercise was considered separately.
Women completing at least two hours of strength training a week had a 20 per cent lower risk of major cardiovascular disease and a 44 per cent lower risk of heart attack than those doing none.
Each additional hour a week was associated with a five per cent lower risk of major cardiovascular disease and a 14 per cent lower risk of heart attack.
The associations weakened somewhat after researchers accounted for body mass index and conditions including diabetes, high blood pressure and high cholesterol, but remained clear.
Body mass index, or BMI, compares weight with height and is commonly used to assess whether someone is within a healthy weight range.
Strength training was also linked to additional benefits among women who did aerobic activity.
Women completing at least two hours of strength training and 150 minutes of aerobic activity each week had a 45 per cent lower risk of heart attack than those reporting no physical activity.
Women who met recommendations for strength training, aerobic activity and reduced television viewing had the lowest risks of major cardiovascular disease, heart attack and stroke compared with those who met some or none of the recommendations.
Zhang said: “These findings suggest that, within an already active population, RT is associated with additional reductions in CVD risk above and beyond overall aerobic activity.
“Alongside aerobic activity and reductions in sedentary behaviour, RT may be an important component of public health strategies for cardiovascular prevention in women.”
The study relied on participants reporting their own resistance training, meaning the data may not always have been precise.
Researchers also noted the possible influence of unmeasured factors and the limited diversity of participants.
They were unable to fully separate the effects of the type of resistance training performed from the overall amount completed.
Dr Harlan M. Krumholz, professor at Yale School of Medicine, said: “We have long encouraged resistance training, and this study provides strong evidence to reinforce that message.
“It should be included in a well-rounded health routine to support function and longevity.”
Women who develop pre-eclampsia face a higher risk of chronic kidney disease and high blood pressure later in life, new research suggests.
The amount of protein found in the urine during pregnancy may help identify those at greatest risk of developing long-term health problems.
Pre-eclampsia usually involves high blood pressure and increased protein in the urine. Some women also experience severe headaches and changes to their vision.
The condition cannot be treated during pregnancy and, in some cases, labour must be induced early to protect both the woman and baby.
The study found that the condition may be linked to longer-term health problems.
Anne Høy Seemann Vestergaard, a medical doctor and PhD at the department of clinical medicine at Aarhus University, said: “What we can see is a clear association between pre-eclampsia and the development of high blood pressure, chronic kidney disease and cardiovascular disease later in life.”
The researchers found that the amount of protein passed in the urine during pregnancy was linked to the risk of developing chronic conditions after giving birth.
Protein in the urine can indicate that the kidneys are not filtering blood normally.
Vestergaard said: “The most surprising finding was how clearly the amount of protein in the urine during pre-eclampsia was linked to the risk of later high blood pressure and chronic kidney disease. Women with moderate to severe protein excretion had a higher risk of both conditions compared with women with low or no protein excretion.”
Among women with pre-eclampsia and moderate to severe levels of protein in the urine, around one in 20 developed chronic kidney disease within 10 years and around one in six developed high blood pressure.
Most women in the study did not develop long-term complications, but the researchers said the increased risk should still be taken seriously because the potential effects can be severe.
Vestergaard said: “At first glance, this may sound like a low number, but it represents a markedly increased risk when the groups are compared. In the group with pre-eclampsia and high levels of protein in the urine, around 1 in 20 women developed chronic kidney disease within ten years, including early stages of the disease, compared with around 1 in 100 in the group with lower or no protein excretion.”
She added: “That is a considerable number in light of the fact that chronic kidney disease is a potentially serious condition that can progress to kidney failure if isn’t diagnosed early.”
The findings suggest women who experience pre-eclampsia may benefit from more systematic monitoring after pregnancy.
Vestergaard said: “Our study suggests that these women may benefit from monitoring of blood pressure and kidney function after pregnancy.”
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