Authors: Elisa Aguzzoli , Dr. Magdalena Walbaum , Prof. Martin Knapp
Care Policy and Evalaution Centre (CPEC), LSE
Dementia is one the biggest health challenges in the world today. It has a huge impact not just on people with the condition, but also on their families and communities who support them. As the number of people with dementia is likely to rise in the coming decades, health and social care systems and governments need to start preparing and addressing this challenge.
What is known about sex and gender differences and dementia?
Women are more likely than men to get dementia, and while living longer plays a part, it is not the only reason. Biological factors like hormonal changes and menopause, and social factors such as fewer opportunities for education in early life, also play a role. Women are often diagnosed later than men, which means treatment starts later and their condition can worsen more quickly.
These differences don’t stop at diagnosis. They also affect how dementia is monitored and treated. There is good evidence that pharmacological and non-pharmacological treatments can slow cognitive decline and improve quality of life. But little research has looked at how dementia care might differ for men and women. This is partly because women are often under-represented in clinical trials, and because research findings are not usually broken down by sex or gender.
How did we explore this topic?
We reviewed the most up-to date research on how dementia affects men and women differently, focusing on access to care, quality of care, and how well treatments work. After searching the literature and carefully checking the studies, we included 16 in our analysis.
What did we find?
We found clear differences between men and women in dementia care, including access to medication and primary care. For example, women are more likely to be given antipsychotic and other psychotropic medications for longer periods, often with less monitoring than men. These drugs are usually not recommended for people with dementia because they increase the risk of falls, diabetes, heart disease, and even death.
Evidence on other treatments is mixed. Exercise may help slow cognitive decline, and some studies suggest it could benefit women more, but it is rare to find study results being reported separately for men and women, making it hard to be sure about these conclusions. Cognitive stimulation therapy, however, seems to provide more benefits for women.
Early trial results for new drugs designed to slow or stop dementia suggest that women may respond less effectively to them than men. Overall, our review found that men and women experience differences in care quality and treatment outcomes. These inequalities need to be considered when planning healthcare, social care support, and other policies.
Why sex and gender matter in dementia care?
To make dementia care fair and effective, we need to understand and address the different ways men and women experience the condition. These differences affect everything, from how quickly people are diagnosed to the treatment and support they receive. At the moment, gaps in research and practice mean that women and men
may respond differently to treatments, and not everyone gets the same quality of care. Health and social care professionals need training to understand these differences, and care plans should take them into account.
Clinical trials should include enough women and men and report the results separately, so that we know how treatments work for different people. Funders can help by supporting research that looks at these issues. Tackling these inequalities will help create dementia care that is fairer, more effective, and more inclusive for everyone.
For the full literature review on which this blog post was based, see:
Aguzzoli, E., Walbaum, M., Knapp, M. et al. Sex and gender differences in access, quality of care, and effectiveness of treatment in dementia: a scoping review of studies up to 2024. Arch Public Health 83, 139 (2025).
https://doi.org/10.1186/s13690-025-01626-z
Elisa Aguzzoli is currently completing a PhD at the London School of Economics and Political Science, as part of the NIHR Three Schools Dementia Programme. To find out more about Elisa and her doctoral research which she hopes will inform future developments in dementia care, please visit Elisa’s profile page
