Greater cognitive reserve may protect against risk of developing AD/pathology.
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Sex differences in reserve may contribute to the elevated rate of AD in women.
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Historically women had less access to reserve contributors, increasing risk for AD.
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Access to reserve contributors benefits both sexes, particularly women.
Abstract
Women represent ⅔ of the cases of Alzheimer’s disease (AD). Current research has focused on differential risks to explain higher rates of AD in women. However, factors that reduce risk for AD, like cognitive/brain reserve, are less well explored. We asked: what is known about sex and gender differences in how reserve mitigates risk for AD? We conducted a narrative review of the literature, with keywords: “sex/gender differences”, “cognitive/brain reserve”, “Alzheimer’s Disease”, and the following cognitive reserve contributors: “education”, “IQ”, “occupation”, “cognitive stimulation”, “bilingualism”, “socioeconomic status”, “physical activity”, “social support”. Sixteen papers disaggregated their data by sex. Those papers observed sex and gender differences in reserve contributors. There is also evidence that greater reserve may be more beneficial in lowering AD risk in women, although more research is needed. We discuss how traditional reserve contributors are gendered and may not capture factors that support cognition in aging women.
