Research increasingly shows that focusing on gender and gender differences can lead to significant breakthroughs in understanding and treating various diseases, including Alzheimer’s disease (AD). However, despite some improvements in recent years, there is still a significant gender gap in medical research, with women often being underrepresented.
WHAM (Women’s Health Access Matters) was recently published The WHAM report, who outlines new research from RAND Corporation to examine the impact of accelerated gender- and gender-based AD, cardiac and autoimmune research on women, their families and the economy. To learn more about the report, the recently released AD results, and what they mean, we spoke to Carolee Lee, WHAM founder and CEO.
Anna MacDonald (AM): Women make up about two-thirds of people with AD. Do we know why women are disproportionately affected? Is there any evidence that there are gender facets of AD that go beyond the fact that women live longer and therefore a larger proportion of the AD population is expected?
Carolee Lee (CL): Alzheimer’s is a highly relevant example of sex and gender research. A growing focus on gender and gender differences shows substantial, innovative breakthroughs in understanding Alzheimer’s disease and its different effects on female and male brains.
Gender differences are evident in identifying Alzheimer’s driveways. For example, research shows that endocrine aging in midlife (perimenopause to menopause) women is linked to a decrease in the brain’s ability to use glucose as its primary fuel, which is critical in producing ATP to meet energy needs Brain cover.
Another driver of Alzheimer’s disease in women during mid-life is increased inflammatory and immune system responses. Functional shifts in both the metabolic and immune systems of the female brain can be prevented by a promising but unproven estrogen therapy in the early stages of the endocrine aging phase.
Closing the gap in Alzheimer’s research in the female brain and in physiology will accelerate interventions and treatments and may influence a precision medicine therapeutic approach.
AM: Which factors are responsible for the gender gap in medical research, including animal research? Are there currently guidelines for including female models / participants in research studies?
CL: The WHAM report shows for the first time that promoting women’s studies is not only good science, but also a good investment.
Women make up 52% of adults over the age of 35 and 66% of people living with Alzheimer’s. Women are twice as likely to develop Alzheimer’s as men. And we know that the disease occurs differently and at different times in the female brain. But only 12% – $ 280 million of the $ 2.4 billion NIH Alzheimer’s research budget went to researching women. That’s like spending $ 3 on research for every woman over 35 and $ 24 for every man.
We know that every cell in the body has a gender and that two-thirds of Alzheimer’s patients are women. Still, animal studies of neurodegenerative diseases that use only men are superior to those that include women at a rate of 5.5 to 1.
Although more women are included in government-funded studies, and this is cause for celebration, many studies do not report results for men and women separately, and women remain severely underrepresented in the early stages of drug and device development. The results are that vital women’s health issues are still out of focus.
There have long been prejudices and barriers to integrating women’s issues and health into research. While progress has been made since 1993 when the National Institutes of Health (NIH) mandated the inclusion of women and minorities in all government-funded health research, there is still a long way to go. It was not until 2016 that the NIH ordered that female mice may also be used in US government-funded animal research. Pharmaceutical and medical device manufacturers do not have to comply with the 1993 regulation, so women are still underrepresented in their studies. And the overwhelming majority of animal testing is still done on male cells.
AM: How important is gender-based research for precision medicine?
CL: Gender-based research is indispensable for precision medicine. The future of medicine lies in bespoke treatments targeting individuals rather than a mathematical average in a table. Precision medicine starts with sex.
AM: What is the impact of accelerated investment in Alzheimer’s disease and related dementia research that is focused on women? Why is data like the WHAM report critical to investing in women’s health research?
CL: The WHAM report, conducted by RAND Corporation, shows us that increasing funding for women’s health research, even in small amounts, has big returns – for women, families, businesses, and our economy. These small investments will add billions of dollars to the economy by increasing the quality of life, labor and economic gains, and lower health care costs.
Doubling funding for Alzheimer’s research in women pays off three times over. A $ 300 million investment generates $ 930 million – a return of 224%. For every US dollar invested, we receive US $ 2.00 in quality of life improvements and US $ 1.24 in healthcare cost savings. We also:
· Eliminate 6,500 Years of Alzheimer’s Disease;
· Add 4,000 years back to the human life;
· Spend 3,600 Years Less in Nursing Homes and Save $ 360 Million;
· Add 13,000 quality of life years to women and 3,000 more to men; and
· Give caregivers over 300 productive years of work back.
The WHAM report finds a return on investment for research focused on women in our initial disease areas – coronary artery disease, rheumatoid arthritis, and Alzheimer’s disease. To the best of our knowledge, no one has yet evaluated the economic consequences of the status quo, the costs and the benefits that we put on the table if women are underrepresented in research.
The creation of this economic argument helps to bolster the case for change and encourages a broad increase in funding for women-centered research.
Carolee Lee spoke to Anna MacDonald, science writer for Technology Networks.
source https://dailyhealthynews.ca/the-value-of-investing-in-sex-and-gender-based-alzheimers-disease-research/
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