Examining Sex Difference for Neurological Health Conditions

By Kate Anastas
Wednesday, March 11, 2020
Specialty: 

Although many neurological health conditions are common to both women and men, symptoms can manifest in distinct ways for women. These considerations may impact the diagnosis and treatment of seemingly non-sex-specific medical conditions in women.

Alzheimer’s Disease

  • 2/3 of Americans diagnosed with Alzheimer’s disease are women.
  • Women diagnosed with Alzheimer’s disease are more likely than men to have brain atrophy and poor memory performance.
  • Women decline more rapidly after diagnosis, due to the difficulty of early detection.

ADHD

  • 3/4 of women with attention deficit/ hyperactivity disorder (ADHD) are underdiagnosed.
  • Because of the focus on hyperactivity in males, particularly at a young age, females are more likely to be diagnosed with ADHD an average of five years later than their male counterparts.
  • Women are more likely to experience psychological distress and low self-image related to ADHD.

Parkinson’s disease

  • Men are two times more likely than women to develop Parkinson’s disease, but women experience faster progression of the disease and a higher mortality rate.
  • Women respond differently to Parkinson’s medications and are more likely to report side effects such as involuntary movements (dyskinesias) due to high levodopa dosage.
  • Women are less likely than men to receive care from a Parkinson’s specialist, neurologist or caregiver.

Differences at every level

There is no one reason why women and men experience the same conditions in different ways — both biological and sociological factors come into play. These factors can be broken down into disease occurrence, disease manifestation, disease perception and disease treatment.

For example, with Alzheimer’s disease, almost two-thirds of people in the U.S. with Alzheimer’s disease are women. Their risk factors include educational level (historically lower than men’s), longevity and — according to recent research by scientists at Kaiser Permanente and the University of California Davis — the length of women’s reproductive periods, with longer reproductive periods appearing to be somewhat protective against Alzheimer’s disease.

When it comes to disease manifestation, women may be diagnosed later in their disease progression than men, possibly because their initial edge in verbal performance masks disease symptoms on memory tests, which are often verbal in nature. Awareness of sex differences in disease progression and presentation could, by inference, improve the potential for early detection and diagnosis, as well as more timely treatment, for a variety of neurological health conditions in both men and women.