Intersectionality in Alzheimer's Disease: The Role of Female Sex and Black American Race in the Development and Prevalence of Alzheimer's Disease

Misiura, Maria B.; Butts, Brittany; Hammerschlag, Bruno; Munkombwe, Chinkuli; Bird, Arianna; Fyffe, Mercedes; Hemphill, Asia; Dotson, Vonetta M.; Wharton, Whitney

doi:10.1007/s13311-023-01408-x

Cited by 13 publications

(3 citation statements)

References 219 publications

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“…Complicating consistent diagnoses is the evolution over time of concepts underlying clinical diagnoses of alcohol misuse or dementias. Thus, publications have considered diagnosis rates by comparing criteria in ICD to DSM , 15 – 17 ICD versions, 18 , 19 DSM-IV to DSM-5 AUD, 20 – 24 ICD AUD, 25 ICD neurocognitive disorders, 26 DSM neurocognitive disorders; 27 bias in AUD 28 , 29 and dementia 30 – 32 diagnoses has also been reviewed.…”

Section: Results Of the Reviewed Studiesmentioning

confidence: 99%

Alcohol Use Disorder and Dementia: A Review

Zahr

2024

ARCR

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PURPOSE By 2040, 21.6% of Americans will be over age 65, and the population of those older than age 85 is estimated to reach 14.4 million. Although not causative, older age is a risk factor for dementia: every 5 years beyond age 65, the risk doubles; approximately one-third of those older than age 85 are diagnosed with dementia. As current alcohol consumption among older adults is significantly higher compared to previous generations, a pressing question is whether drinking alcohol increases the risk for Alzheimer’s disease or other forms of dementia. SEARCH METHODS Databases explored included PubMed, Web of Science, and ScienceDirect. To accomplish this narrative review on the effects of alcohol consumption on dementia risk, the literature covered included clinical diagnoses, epidemiology, neuropsychology, postmortem pathology, neuroimaging and other biomarkers, and translational studies. Searches conducted between January 12 and August 1, 2023, included the following terms and combinations: “aging,” “alcoholism,” “alcohol use disorder (AUD),” “brain,” “CNS,” “dementia,” “Wernicke,” “Korsakoff,” “Alzheimer,” “vascular,” “frontotemporal,” “Lewy body,” “clinical,” “diagnosis,” “epidemiology,” “pathology,” “autopsy,” “postmortem,” “histology,” “cognitive,” “motor,” “neuropsychological,” “magnetic resonance,” “imaging,” “PET,” “ligand,” “degeneration,” “atrophy,” “translational,” “rodent,” “rat,” “mouse,” “model,” “amyloid,” “neurofibrillary tangles,” “α-synuclein,” or “presenilin.” When relevant, “species” (i.e., “humans” or “other animals”) was selected as an additional filter. Review articles were avoided when possible. SEARCH RESULTS The two terms “alcoholism” and “aging” retrieved about 1,350 papers; adding phrases—for example, “postmortem” or “magnetic resonance”—limited the number to fewer than 100 papers. Using the traditional term, “alcoholism” with “dementia” resulted in 876 citations, but using the currently accepted term “alcohol use disorder (AUD)” with “dementia” produced only 87 papers. Similarly, whereas the terms “Alzheimer’s” and “alcoholism” yielded 318 results, “Alzheimer’s” and “alcohol use disorder (AUD)” returned only 40 citations. As pertinent postmortem pathology papers were published in the 1950s and recent animal models of Alzheimer’s disease were created in the early 2000s, articles referenced span the years 1957 to 2024. In total, more than 5,000 articles were considered; about 400 are herein referenced. DISCUSSION AND CONCLUSIONS Chronic alcohol misuse accelerates brain aging and contributes to cognitive impairments, including those in the mnemonic domain. The consensus among studies from multiple disciplines, however, is that alcohol misuse can increase the risk for dementia, but not necessarily Alzheimer’s disease. Key issues to consider include the reversibility of brain damage following abstinence from chronic alcohol misuse compared to the degenerative and progressive course of ...

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Section: Results Of the Reviewed Studiesmentioning

confidence: 99%

Alcohol Use Disorder and Dementia: A Review

Zahr

2024

ARCR

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“…Intersectionality represents a multidimensional approach useful to understand how these interlaced elements interact to shape our identity, behaviors, and complex interpersonal relationships [68]. An intersectional analysis is progressively taking hold also in clinical research, particularly tackling areas such as addictions [69], neurological disorders [70], or infectious diseases [71].…”

Section: Discussionmentioning

confidence: 99%

Sex- and Gender-Based Analysis on Norepinephrine Use in Septic Shock: Why Is It Still a Male World?

Perna,

Raparelli,

Tordo Caprioli

et al. 2024

Microorganisms

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Sex and gender are fundamental health determinants and their role as modifiers of treatment response is increasingly recognized. Norepinephrine is a cornerstone of septic shock management and its use is based on the highest level of evidence compared to dopamine. The related 2021 Surviving Sepsis Campaign (SCC) recommendation is presumably applicable to both females and males; however, a sex- and gender-based analysis is lacking, thus not allowing generalizable conclusions. This paper was aimed at exploring whether sex- and gender-disaggregated data are available in the evidence supporting this recommendation. For all the studies underpinning it, four pairs of authors, including a woman and a man, extracted data concerning sex and gender, according to the Sex and Gender Equity in Research guidelines. Nine manuscripts were included with an overall population of 2126 patients, of which 43.2% were females. No sex analysis was performed and gender was never reported. In conclusion, the present manuscript highlighted that the clinical studies underlying the SCC recommendation of NE administration in septic shock have neglected the likely role of sex and gender as modifiers of treatment response, thus missing the opportunity of sex- and gender-specific guidelines.

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“…APOE4 has been established as the strongest genetic risk factor for late-onset AD and dementia, while APOE2 is, to some extent, neuroprotective. APOE4 increases the risk of AD while the ε2 form decreases the risk compared to having the ε3 form [170,171]. Those with one copy of ε4 may have a threefold increased risk of AD compared to those with two copies of the ε3 form, and the risk increases up to 8-12 times higher if they have two copies of the ε4 form.…”

Section: Cognitive Decline and Alzheimer's Diseasementioning

confidence: 99%

Healthy Aging in Menopause: Prevention of Cognitive Decline, Depression and Dementia through Physical Exercise

Guerrero-González,

Cueto-Ureña,

Cantón-Habas

et al. 2024

Physiologia

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The aging of the global population is a significant and complex phenomenon with far-reaching implications for healthcare systems and society. By 2030, it is projected that the number of individuals over the age of 65 will increase by nearly 1 billion, largely due to advancements in healthcare and improvements in quality of life. Aging is a multifaceted process that encompasses a wide array of changes, spanning from the cellular level to the intricate physiological systems of the human body. At the central nervous system level, aging represents a major risk factor for conditions such as depression and cognitive impairment, which are likely linked to neuroinflammatory processes and can potentially lead to more severe dementias, including Alzheimer’s disease (AD). The higher prevalence of AD in women compared to men has led to speculation that the onset of menopause and associated phenomena, particularly the decline in estrogen levels, may play a role in the development of the disease. Furthermore, research has shown that physical exercise confers both physical and mental health benefits to older adults, with women potentially experiencing the greatest advantages. Understanding the multifaceted nature of aging and its implications for health will ensure that older adults receive the support and care essential for maintaining their health and quality of life.

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Intersectionality in Alzheimer's Disease: The Role of Female Sex and Black American Race in the Development and Prevalence of Alzheimer's Disease

Cited by 13 publications

References 219 publications

Alcohol Use Disorder and Dementia: A Review

Alcohol Use Disorder and Dementia: A Review

Sex- and Gender-Based Analysis on Norepinephrine Use in Septic Shock: Why Is It Still a Male World?

Healthy Aging in Menopause: Prevention of Cognitive Decline, Depression and Dementia through Physical Exercise

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