Sex Differences in Cardiovascular Disease and Cognitive Impairment: Another Health Disparity for Women?

Abstract

Although the number of Americans dying of cardiovascular disease (CVD) continues to increase since 2010 after decades of decrease, advances in the management of CVD have led to increased longevity among both women and men, with more people, mostly women, now surviving into their 80s and beyond.1 Paralleling this increased longevity, however, is an increasing prevalence of, and mortality from, neurodegenerative cognitive disorders.1 These cognitive disorders include dementia, a syndrome that has a multitude of causes and symptoms that ultimately have substantial impact on social and occupational activities and aspects of daily living.2 Typical symptoms of dementia include changes in memory, problem solving, language, and executive functioning.2 Although there are often distinct patterns, symptoms, and specific brain pathology associated with different dementias, multiple autopsy studies are now demonstrating that people with symptoms of a dementia will often have multiple brain pathologies noted at autopsy that were associated with the dementia.3, 4 Multiple reports document that approximately two thirds of those clinically diagnosed with Alzheimer dementia are women.5 Furthermore, it is estimated that by 2040 the number of Americans with some form of cognitive impairment (CI), including dementia, will be ≈8.3 million women and ≈3.3 million men.5 This sex‐related CI disparity is concerning and raises important questions about its possible relation to CVD and CVD‐related risk factor conditions.