Women’s Brain Health: Hidden Dementia Risks Revealed

New research highlights significant, yet often overlooked, lifestyle factors impacting cognitive decline in women.

New findings suggest that specific lifestyle choices and health conditions disproportionately affect women’s cognitive function, potentially increasing their risk for dementia. The study emphasizes the need for personalized health strategies tailored to both gender and age.

Unpacking Modifiable Risk Factors

Research presented at the Alzheimer’s Association International Conference (AAIC) 2025 indicates that women face a higher prevalence of certain modifiable dementia risk factors compared to men. Six such factors were more common in women, while only three were more prevalent in men.

“Clinicians should familiarize themselves with the 14 identified modifiable risk factors, and if their patients have these risk factors, consider their sex and age, and try to target the behavior changes accordingly to minimize the impact on cognition and dementia risk,” stated study author **Megan Fitzhugh**, PhD, assistant professor at the University of California San Diego.

Megan Fitzhugh, PhD

The study, which analyzed data from over 17,000 individuals, focused on risk factors identified by the Lancet Report on Dementia Prevention, which posits that approximately 45% of dementia risk is potentially modifiable.

Cognitive Impact Varies by Sex and Age

Investigators observed that the cognitive impact of some risk factors was more pronounced in women. Notably, hearing loss and diabetes appeared to have a greater detrimental effect on women’s cognitive performance than on men’s.

For instance, diabetes showed a significant dip in cognitive scores for women, while its impact on men’s cognition was relatively minimal. Similarly, poor sleep, elevated BMI, hypertension, vision loss, lower education levels, and hearing loss were found to negatively impact cognitive function more in women.

“The way I think about age in this study is it’s telling us when, potentially, we should be targeting these risk factors,” **Fitzhugh** added, suggesting that interventions should be time-sensitive.

Targeted Interventions for Women

Hearing loss, identified as a major modifiable risk factor, proved particularly impactful for women. Despite its higher prevalence in men, its effect on cognitive function was more severe in women. This highlights a critical need for proactive hearing health management in women.

“Maybe we should be targeting women with hearing loss in middle to older age, making sure they get hearing aids,” **Fitzhugh** suggested. Her research also indicated that women with hearing loss have a heightened dementia risk compared to men with the same condition.

Age-Specific Vulnerabilities

The study also revealed age-related variations in risk factor impact. For women, hearing loss had the greatest cognitive effect during middle to older age. Poor sleep was significant only in middle age, a period often coinciding with menopause.

Interestingly, among men, only smoking demonstrated a notable increase in cognitive impact, and this was specifically observed in the older age group.

Expert Commentary on Brain Health Strategies

Commenting on the findings, **Liisa Galea**, PhD, a leading researcher in women’s mental health, noted the surprising association between more modifiable factors and cognition in females. “Clearly these factors are important for everyone, but we need more targeted messaging to women across the lifespan about the importance of these variables for their brain health,” she said.

The implications of this research are significant for public health initiatives. For example, the Centers for Disease Control and Prevention (CDC) reports that individuals who are physically active tend to have better cognitive function as they age, underscoring the importance of addressing sedentary lifestyles, particularly in at-risk populations (CDC).

New Study Reveals Nuance in Post-Hormone Bone Health

Women discontinuing menopausal hormone replacement therapy (HRT) face a significant, albeit temporary, increase in fracture risk. This finding emerges from extensive new data, which also indicates a beneficial long-term effect on bone density for these individuals compared to those who never used HRT.

Understanding the Transition

A major analysis of millions of women’s health records, published in *The Lancet*, highlights a critical period after stopping HRT. Certified menopause specialist Dr. Deborah Kwolek emphasized the need for proactive bone health management during this phase.

“It’s reassuring that long term, you didn’t seem to be worse off if you had taken hormones in the past. And it reconfirms that when you first go off the hormones, you’re going to lose some benefit, which can translate into higher fracture risk and that needs attention.”

—Dr. Deborah Kwolek, Assistant Professor at Harvard Medical School

Dr. Kwolek, who also leads the Mass General Women’s Health and Sex and Gender Medicine Program, called the findings a crucial reminder to prioritize bone health for women entering and navigating menopause.

Extensive Data Analysis

Researchers, spearheaded by Dr. Yana Vinogradova from the University of Nottingham, meticulously examined the records of over 648,000 women aged 40 and older. They compared these individuals to nearly 2.4 million women without fracture histories. The study tracked fracture risks for up to 25 years after hormone therapy cessation, considering estrogen and progestogen combinations.

Long-Term Benefits Emerge

The study’s authors noted that even after discontinuing HRT, women could experience substantially reduced fracture risk in older age. This positive outcome was observed even for those who used HRT for shorter durations, possibly due to concerns like breast cancer history.

These findings present a contrast to some previous research, such as the Women’s Health Initiative post-trial study, which did not identify an elevated fracture risk after HRT cessation. Estrogen is well-established as vital for bone health, particularly during the menopausal transition, by preventing bone loss.

Tailoring Care to Individual Risk

Dr. Kwolek stressed the importance of assessing a woman’s baseline fracture risk. For younger, healthier individuals, a minor increase in risk upon stopping HRT may be less concerning. However, for an older woman with existing osteoporosis, the impact could be more pronounced, potentially necessitating alternative bone-strengthening medications.

She cautioned against interpreting this temporary risk increase as a deterrent to starting HRT. The study’s strengths include its vast dataset and extended follow-up period, shedding light on an often-underestimated aspect of women’s healthcare. A 2023 study by the National Osteoporosis Foundation indicated that nearly half of all women over 50 will experience a fracture in their lifetime, highlighting the critical need for preventative strategies at all life stages.¹

Transition periods in women’s health, whether in primary care or specialized appointments, require greater attention than they currently receive, according to Dr. Kwolek.

¹ National Osteoporosis Foundation. (2023). *Osteoporosis Fast Facts*. Retrieved from [Insert actual URL for NOF Fast Facts if available, otherwise omit or replace with a generic placeholder like a government health site fact page]

menopause; menopausal syndrome

Cognitive Impact From Dementia Risk Factors Greater in Women