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Why Alzheimer's Hits Women Harder


Now we want to turn to some new facts about Alzheimer's. A new report says women are hit hardest by this disease. Nearly two-thirds of people with Alzheimer's are women, and when it comes to caregiving, women are two and a half times more likely than men to provide 24-hour care to somebody with Alzheimer's, this according to new research from the Alzheimer's Association. We wanted to know more about this, so we've called Angela Geiger. She's chief strategy officer at the Alzheimer's Association. We caught up with her in Los Angeles. Welcome. Thanks so much for joining us.

ANGELA GEIGER: Oh, thank you for having me.

MARTIN: Could you just remind us briefly what Alzheimer's is?

GEIGER: Alzheimer's is a progressive and fatal disease. Lots of people ask the question what the difference between Alzheimer's and dementia is. And dementia is actually the set of symptoms that you see, and Alzheimer's is the cause of most dementias.

MARTIN: You call it a public health crisis. Why do you call it that?

GEIGER: There are 5 million Americans with Alzheimer's disease. That number's set to spike to as many as 16 million by the middle of the century. And Alzheimer's disease is already the most costly disease in this nation. We simply cannot afford, economically or the toll on families, to not make progress in detection and treatment before those numbers spike.

MARTIN: Do we know what causes Alzheimer's?

GEIGER: Alzheimer's disease is the only one in the top 10 causes of death that we don't know how to treat, prevent or even slow its progression. There's still many, many mysteries around Alzheimer's disease, and we need a lot more federal research funding to figure them out.

MARTIN: We mentioned that almost two-thirds of Alzheimer's patients are women. Why is that?

GEIGER: Well, the primary reason that more women than men have Alzheimer's disease is because women live longer. But there's also lots of questions that are still out there. There's well-known gender structural differences in the brain, hormonal differences. And one of those key research questions is to find out more about is there something more than just lifetime risk.

MARTIN: We know that it's associated with advanced old age, but we don't really know what causes it.

GEIGER: Right. The greatest risk factor for Alzheimer's disease is age. But we know there's - it's a very complex disease, and clearly there's other things going on. And again, we just need more research to start to figure that out.

MARTIN: And I want to talk a little bit about caregiving. You're saying that women are much more likely to be primary caregivers to somebody with Alzheimer's. Why is that?

GEIGER: Well, you know, again, that's a place where there's probably societal issues around that. One of the things we do know that just happened in our Alzheimer's Association Women and Alzheimer's poll is that almost 40 percent of caregivers said they became a caregiver because they didn't feel like they had a choice. So there's a lot of women out there who are in their - you know, in that sandwich generation who are caring for aging parents, as well as their kids at home.

MARTIN: And when you say that they didn't have a choice, it's because why? I mean, the cost of paying somebody to provide that care would be just so prohibitive that they just couldn't possibly - just can't afford it? Or is it that they feel that the person's needs are so demanding that they can't trust someone else to do it? Do you know?

GEIGER: You know, I think both things are true. You know, I get the opportunity to talk to families all across the country who are going through this Alzheimer's disease journey. Alzheimer's caregiving is really hard, particularly in the later stages of the disease where it requires real hands-on care for just, you know, eating, bathing, all those kind of things. So why people feel they don't have a choice is a variety of factors. It can be economic. It also may be a family choice preference to keep someone at home or do that themselves, or other cultural factors also play a role in it. One of the interesting things we found in our recent poll was that women are two and a half more times likely than men to do that really active hands-on care that happens at the end of those later stages of Alzheimer's disease. And it's very emotionally as well as physically taxing.

MARTIN: There are other things that you wanted to talk about in this poll, too, as I understand it, that you feel that people have a lot of myths about Alzheimer's that you wanted to dispel. Could you talk a little bit about that? Or what are some of the common misperceptions or misconceptions that people have about it? And what would you like people to know?

GEIGER: There are a lot of misperceptions about Alzheimer's disease, the most common being that people don't necessarily think of it as a disease. Alzheimer's is a disease of the brain, and it's progressive and ultimately fatal. In fact, it's the sixth leading cause of death in the United States. Most people don't know that. But one of the really interesting things that came out of the poll was that there's this strong misperception - it's a mistaken belief that Alzheimer's has to run in your family for you to be at risk for Alzheimer's. And it's just not true. In fact, 24 percent of both men and women agreed with that. And then there were even bigger differences based on...

MARTIN: Ethnicity.

GEIGER: ...Ethnicity. Yeah.

MARTIN: Yeah, I understand - I saw that. I saw that, too, that there were some large ethnic differences in the misunderstanding that Alzheimer's has to be something that runs in your family in order for you to get it, that 33 percent of Hispanics polled thought that. And nearly half of the Asians who were polled by you thought that. And that is simply not true. That is - why do you think that is? Any ideas?

GEIGER: That actually was a really surprising finding for us, and it's made us really think about what kind of outreach and education we need to be doing at the Alzheimer's Association in different populations to help correct that myth.

MARTIN: Can I just clarify one other thing? You said it's the sixth-leading cause of death in this country. How does one die from Alzheimer's? How does it cause death?

GEIGER: Alzheimer's causes death in a couple of different ways. The most direct when you die because of Alzheimer's is because your body - you know, everyone thinks about Alzheimer's and memory. You know, you forget things. You forget people. Well, ultimately, your body forgets how to do things like eat and breathe. So your body eventually just shuts down because of the Alzheimer's disease. And then there's also lots of times that people die with Alzheimer's disease or because of Alzheimer's disease because of bedsores or pneumonia or those kind of related things. But one of the interesting things about Alzheimer's mortality rates is that they're vastly underreported, that while Alzheimer's disease, you know, right now is the sixth-leading cause of death, we know that many, many more people die from Alzheimer's disease than those official reports.

MARTIN: What is it that you were hoping to accomplish with this poll? I confess that normally we would not use a poll by an association because the assumption would be that it's kind of self-serving, that you're looking for what you hope to find, right? I mean, just to be honest about it. But this research demonstrates some patterns that I think are hard to ignore. I mean - you know what I mean? The findings are so overwhelming it seems like it would be really hard to ignore the preponderance, you know, of evidence that - particularly on the gender balance question here and a number of these other factors. So, I mean, what is the most important thing that you're hoping people draw from this information?

GEIGER: You know, this most recent poll really builds on the work that we originated back in 2010 with Maria Shriver and The Shriver Report. And so these trends have remained really true over time about this burden of Alzheimer's and women. And we thought it was time to go back out in the field and look and see what had changed. And what we found was, in some cases, things are even harder today for women when it comes to Alzheimer's disease than it was even a few years ago. And that's why we're launching a brand-new women's initiative to - we're asking a million women to go to and tell us why her brain matters and how she's going to use it to wipe out Alzheimer's disease. We really think that women are smart and amazing and can solve big problems, and Alzheimer's is the public health crisis that must be solved.

MARTIN: Angela Geiger is chief strategy officer at the Alzheimer's Association. She joined us from Los Angeles. Angela, thanks so much for speaking with us.

GEIGER: Thank you. Transcript provided by NPR, Copyright NPR.