Inequality in Alzheimer’s: double the prevalence in women, lower representation in clinical trials, and greater caregiving burden

The prevalence of the disease in women is due, among other factors, to biological aspects such as hormonal changes during menopause. Ace Alzheimer Center Barcelona calls for greater equality in clinical trials to prevent gender bias in research. Two out of three caregivers are women, which affects their professional development, economic stability, and emotional well-being.  

Alzheimer’s is a predominantly female disease. Women have twice the risk of developing it compared to men and, among those over the age of 55, prevalence is 7.1% in women versus 3.3% in men. However, although women represent the majority of those affected, they are not equitably represented in clinical trials. In addition, the role of caregiver largely falls on them: two out of three people caring for Alzheimer’s patients are women.

On the occasion of International Women’s Day, Ace Alzheimer Center Barcelona wishes to acknowledge this reality and highlight the role of women in a disease that places them at the forefront in a dual role: as patients and as caregivers.

“The data are clear: Alzheimer’s disproportionately affects women. Recognizing their role is essential to move towards fairer, more precise research with a true gender perspective”, states Dr. Mercè Boada, Medical Director of Ace Alzheimer Center Barcelona.

Why does it affect women more?

The higher prevalence of Alzheimer’s in women is due to a combination of biological and social factors. From a genetic perspective, certain profiles are known to increase the risk more in women than in men. Added to this are the hormonal changes women experience throughout their lives: the decline in estrogen levels during menopause is associated with a higher risk of dementia, as it makes the brain more vulnerable to deterioration.

Other health conditions that are more common in women, as well as the higher use of certain medications that may affect cognitive function, also play a role.

Educational level is also considered a determining factor in the prevalence of Alzheimer’s. In Spain, many women from past generations did not have access to basic education, which increases their risk of developing Alzheimer’s. However, this difference could decrease in the future.

Lower representation in clinical trials despite higher prevalence

Although women make up the majority of those affected, they are not equitably represented in clinical trials. Research conducted by Ace Alzheimer Center Barcelona shows that women are 26% less likely to be selected to participate.

Among the main reasons is the lower educational level in older age groups, which makes it more difficult to apply certain standardized neuropsychological tests that largely depend on literacy. This situation highlights the urgent need to adapt diagnostic criteria and tools to avoid gender bias in research.

Maitée Rosende-Roca, neurologist at Ace Alzheimer Center Barcelona, authored a study confirming that the high number of women with Alzheimer’s and low educational levels requires a gender-focused approach in clinical research.

“It is essential to improve assessment and diagnostic tools so that they are sensitive to educational level, with the aim of achieving greater representation of women in clinical trials”, states Dr. Rosende-Roca.

Two roles, same gender: patients and caregivers

The impact of Alzheimer’s on women is not limited to prevalence. In addition to being affected in greater proportion, women are also the ones who most often take on the care of those who suffer from the disease. According to studies by Ace Alzheimer Center Barcelona, when a man develops dementia, the primary caregiver is most commonly his wife or daughter-in-law. This reality has direct consequences for women’s professional development, economic stability, and emotional well-being.

Seventy-three percent of those who participate in caregiver workshops and support groups at Ace are women, highlighting that they continue to assume this responsibility to a greater extent. Through its Social Work department, Ace Alzheimer Center Barcelona provides training and emotional support to caregivers, offering tools to help reduce caregiver burden.

“Caring for a person with Alzheimer’s is a long, complex, and deeply exhausting process, both emotionally and physically. That is why we must recognize and value the essential role of caregivers, who sustain this indispensable work every day. Without them, addressing Alzheimer’s would simply not be possible” concludes Mercè Boada.

About Ace Alzheimer Center Barcelona, a pioneering model in the field of Alzheimer’s

Ace Alzheimer Center Barcelona, an innovative organization and a benchmark in Spain, was founded in 1995 with the aim of meeting the growing demand for the diagnosis and treatment of people with cognitive impairment and dementia, especially Alzheimer’s disease. It provides personalized care and comprehensive support to patients and their families through a telemedicine-based model that ensures care and assistance for all people with Alzheimer’s and their relatives from anywhere in the country.

Each year, its Diagnostic Unit cares for nearly 9,000 people, more than 4,000 of whom have dementia (3,000 of them with Alzheimer’s disease). Early-stage diagnosis of dementia is a priority for Ace Alzheimer Center Barcelona, which is why it promotes free memory check-ups, also available online through FACEmemory®. Ace Alzheimer Center Barcelona is considered one of the international leaders in research, particularly in clinical, neuropsychological, social, and basic research. Among other research activities, it participates in numerous global clinical trials covering all stages of the disease. It has also led two European Union-funded research projects on Alzheimer’s genetics (ADAPTED) and on active patient participation models (MOPEAD).

  For more information: