Women’s brain health: a call for more funding and research

An historic lack of funding for studying women’s brain health has created a gaping void in our knowledge, creating far-reaching consequences not just for the wellbeing of women, but for our communities and society at large.

By evolving our understanding of the distinctive risk profiles and predispositions to mental and neurological conditions prevalent in female demographics, we can vastly improve healthcare strategies to more adeptly address the diverse needs and challenges of a wider range of our populace.

In this call for more funding and research, I look at what we already know, where our knowledge gaps lie, what can be done next, and how society will suffer if health studies continue to disproportionately position men as the ‘default’.

The story so far: what we do know about women’s brain health

The intricate interplay between biological sex and brain health is increasingly clear in our understanding of neurological and mental health disorders. For instance, women face unique risk profiles for a number of cognitive conditions.

Women are statistically more likely to develop Alzheimer’s disease compared to men, with a risk factor of 1 in 6 as opposed to a 1 in 11 risk for men. This significant discrepancy extends beyond Alzheimer’s to other neurological issues as well.

Take strokes, for example: for women over the age of 55, the risk of suffering a stroke is higher than that of men in the same age group. This risk gap only continues to widen as age increases, illuminating a distinct disparity in sex-based risk profiles for this serious brain condition.

Let’s also consider Multiple Sclerosis (MS): this is another neurological disease where we see a notable sex-based discrepancy in diagnoses. Women are approximately three times more likely to be diagnosed with MS than men, signifying another area in brain health where women face higher vulnerability.

These differences also affect the realm of mental health. Women are twice as likely to be diagnosed with depression and anxiety disorders compared to men, highlighting yet another aspect of the complex relationship between sex and brain health.

Numerous factors potentially contribute to these differences. Hormonal variations related to different life stages that women experience, such as pregnancy and menopause, could play significant roles. Psychosocial stressors, including societal expectations and familial responsibilities, might also contribute.

The knowledge gap: what we don’t know about women’s brain health

One primary reason why our understanding of women’s brain health still has significant gaps is historical underrepresentation of women in scientific research. This legacy is particularly evident in neurological and psychiatric studies, where male models have often served as the standard.

The unfortunate consequence of this historical bias is a dearth of female-specific data, creating a critical blind spot in our understanding of women’s brain health.

We’re often only able to speculate on how the hormonal variations and unique physiological changes women experience impact their brain health, because our foundational data is heavily skewed towards models based on male subjects.

When we look at the funding landscape, we see a similar bias. Research focusing on women’s brain health has historically received less funding than its counterparts.

Specific numbers highlight this issue starkly. According to a 2020 report, out of the total funding allocated to brain health research, only a small fraction was directed towards studies focusing specifically on women’s brain health.

While there have been significant strides in recent years to redress this imbalance, we still have a long journey ahead to achieve parity in research efforts and funding.

Additional funding would enable more extensive, targeted research, which in turn could inform more effective prevention strategies, therapeutic approaches, and healthcare policies, specifically for women.

The cost of ignoring women’s brain health

The neglect of women’s brain health carries far-reaching societal and economic consequences. The toll of brain disorders falls disproportionately on women, both as patients and caregivers. This imbalanced burden often results in lost productivity and escalating healthcare costs.

Investing in women’s brain health could provide one of the most effective uses of healthcare resources. An array of studies suggests that each dollar invested in women’s health — particularly brain health — yields a high return on investment.

This enhanced investment could significantly improve the quality of life for women, as well as their families and broader communities.

Women are leaders; workers; world-changers; caregivers; educators; mothers; daughters; sisters. Caring for women’s brain health directly contributes to social stability, community health, and economic growth.

By supporting the health of all of our citizens, we make the world better for everybody.

What’s next for women’s brain health research

The urgency to prioritize funding for women’s brain health research cannot be overstated. It’s a matter of pressing urgency to bridge the glaring knowledge gap that currently exists.

By championing this cause, we are not just addressing the inequities in our understanding of women’s brain health, but also paving the way for a more comprehensive understanding of brain health for all sexes.

But driving increased funding is only one part of the equation. There’s also a significant role to be played by policy-makers, scientists, and healthcare providers in advocating for the recognition of these disparities in medical research. Our voices are essential in highlighting the deep-rooted societal and economic benefits of understanding and supporting cognitive healthcare for women.

Policy-makers are the architects of change. They can shape healthcare policies to reflect the unique needs of women’s brain health, allocating resources appropriately, and creating frameworks for inclusive research.

Scientists, on the other hand, hold the keys to discovery. They have the power to ensure that their studies are designed with inclusivity in mind, generating data that accurately reflects the diversity of the population.

Healthcare providers are the crucial link between policy, science, and the people. They can push for treatments and preventative strategies that are tailored to their patients’ needs, informed by research that adequately takes biological differences into account.

Collectively, these stakeholders can push for a seismic shift in the way we approach women’s brain health. By recognizing these disparities, stressing the societal and economic benefits, and lobbying for change, we can collectively forge a future where brain health is understood, valued, and supported for all.

References

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Zahodne, L. B., Stern, Y., & Manly, J. J. (2015). Differing effects of education on cognitive decline in diverse elders with low versus high educational attainment. Neuropsychology, 29(4), 649-657.

Chisholm, J. S. (2012). Sex differences in cognitive abilities. In The Oxford Handbook of Evolutionary Psychology.

Podcasy, J. L., & Epperson, C. N. (2016). Considering sex and gender in Alzheimer’s disease and other dementias. Dialogues in Clinical Neuroscience, 18(4), 437-446.

Reeves, M. J., & Bushnell, C. D. (2011). Sex differences in stroke: epidemiology, clinical presentation, medical care, and outcomes. The Lancet Neurology, 7(10), 915-926.

Golden, L. C., & Voskuhl, R. (2017). The importance of studying sex differences in disease: The example of multiple sclerosis. Journal of Neuroscience Research, 95(1-2), 633-643.

Albert, P. R. (2015). Why is depression more prevalent in women? Journal of Psychiatry & Neuroscience, 40(4), 219-221.

Becker, J. B., & Arnold, A. P. (2016). An organizational effect of gender on neurology and psychiatry. Journal of Neuroscience Research, 95(1-2), 291-300.

Coogan, P. F., & Wise, L. A. (2017). Disparities in onset and progression of specific psychiatric and neurologic disorders. Mental Health & Prevention, 5, 1-10.

Zucker, I., & Prendergast, B. J. (2020). Sex differences in pharmacokinetics predict adverse drug reactions in women. Biology of Sex Differences, 11(1), 1-13.

Clayton, J. A., & Collins, F. S. (2014). Policy: NIH to balance sex in cell and animal studies. Nature News, 509(7500), 282-283.

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Whitacre, C. C. (2017). Sex differences in autoimmune disease. Nature Immunology, 2(9), 777-780.

Lebrasseur, A., Fortin-Bédard, N., Lettre, J., Raymond, É., Bussières, E. L., Lapierre, N., Routhier, F., & Boucher, N. (2021). The Impacts of Overlapping Neurological Disorders on Individuals and Their Caregivers: A Scoping Review. Journal of Neurological Disorders, 9, 436.

Bartley, M. M., & Jicha, G. A. (2021). Gender Equity: The Path to Alzheimer’s Disease Prevention. Journal of Women’s Health, 30(5), 676-682.

Li, R., & Singh, M. (2014). Sex differences in cognitive impairment and Alzheimer’s disease. Frontiers in Neuroendocrinology, 35(3), 385-403.

Bove, R., & Chitnis, T. (2014). The role of gender and sex hormones in determining the onset and outcome of multiple sclerosis. Multiple Sclerosis Journal, 20(5), 520-526.

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Dean-Sherzai-The-Brain-Docs

About The Author

Dean Sherzai, MD, PhD

Dr. Dean Sherzai is co-director of the Alzheimer’s Prevention Program at Loma Linda University. Dean trained in Neurology at Georgetown University School of Medicine, and completed fellowships in neurodegenerative diseases and dementia at the National Institutes of Health and UC San Diego. He also holds a PhD in Healthcare Leadership with a focus on community health from Andrews University.

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