With the aging of the population, the burden of Alzheimer's disease (AD) is rapidly expanding. More than 5 million people in the US alone are affected with AD and this number is expected to triple by 2050. While men may have a higher risk of mild cognitive impairment (MCI), an intermediate stage between normal aging and dementia, women are disproportionally affected with AD. One explanation is that men may die of competing causes of death earlier in life, so that only the most resilient men may survive to older ages. However, many other factors should also be considered to explain the sex differences. In this review, we discuss the differences observed in men versus women in the incidence and prevalence of MCI and AD, in the structure and function of the brain, and in the sex-specific and gender-specific risk and protective factors for AD. In medical research, sex refers to biological differences such as chromosomal differences (eg, XX versus XY chromosomes), gonadal differences, or hormonal differences. In contrast, gender refers to psychosocial and cultural differences between men and women (eg, access to education and occupation). Both factors play an important role in the development and progression of diseases, including AD. Understanding both sex- and gender-specific risk and protective factors for AD is critical for developing individualized interventions for the prevention and treatment of AD.

译文

随着人口的老龄化,阿尔茨海默氏病(AD)的负担正在迅速扩大。仅在美国,就有超过500万人患有AD,预计到2050年,这一数字将增加三倍。尽管男性轻度认知障碍(MCI)的风险较高,轻度认知障碍是正常衰老与痴呆症之间的中间阶段,但女性比例却不成比例。受AD影响。一种解释是,男人可能会在生命的早期死于竞争性死亡原因,因此只有最有韧性的男人才能生存到更高的年龄。但是,还应考虑许多其他因素来解释性别差异。在这篇综述中,我们讨论了男性和女性在MCI和AD的发生率和患病率,大脑的结构和功能以及针对性别的性别和性别特异性风险及保护因素方面的差异。在医学研究中,性别是指生物学差异,例如染色体差异(例如XX与XY染色体),性腺差异或荷尔蒙差异。相反,性别是指男人和女人之间的社会心理和文化差异(例如,获得教育和职业的机会)。这两个因素在包括AD在内的疾病的发生和发展中都起着重要作用。理解针对性别的性别风险和针对性别的风险因素以及保护因素对于开发预防和治疗AD的个性化干预措施至关重要。

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