Cognitive Decline in Women: The ZARADEMP Study

  • Patricia Gracia-GarcíaEmail author
  • Elena Lobo
  • Javier Santabárbara
  • Concepción de la Cámara
  • Raúl López-Antón


The burden of cognitive impairment and dementia is rapidly expanding with the aging of the population worldwide. Globally, the number of people living with dementia all over the world in 2015 was 46.8 million and is predicted to triple by 2050. In this chapter, we first describe the cognitive aging profile in women: they perform better than men in tasks related to memory. We then summarize epidemiological cognitive impairment and dementia data, specifically in women: despite controversial data for mild cognitive impairment (MCI), several data in literature support that the prevalence of dementia is higher among women, specifically Alzheimer’s disease (AD). We finally discuss the potential risk and protective factors for cognitive impairment and dementia, specifically in women when there is evidence in the available literature. Women have a higher life expectancy than men, and men who survive to older ages might be healthier and have fewer risk factors for dementia than women. Aside from this survival bias, other biological, societal, and cultural factors may affect women and men differently: estrogen depletion in menopause, depression, obesity, diabetes, hypertension, smoking, alcohol, educational and occupational attainment, and physical exercise. In conclusion, there is a need to prioritize dementia as a global women’s health issue, and future studies on cognitive impairment and dementia should stratify their analysis by sex: understanding factors related to cognitive impairment and dementia specifically in women is crucial for developing interventions for their prevention which target specifically to these factors.


Alzheimer’s disease Cognitive impairment Dementia Gender differences Risk factors Sex differences 


Conflict of Interest

P. Gracia-García has received honorarium and support for attendance to scientific meetings from Servier and Pfizer; C. de la Cámara has received funding to attend scientific meetings from Janssen, Lundbeck, and Otsuka. None of these companies have influenced the content of this work. The other authors declare that they have no conflict of interest.

Funding: The ZARADEMP study was supported by the Fondo de Investigación Sanitaria (FIS), Instituto de Salud Carlos III, Gobierno de España (PI 94-1562, 97-1321E, 99-0608, 01-0255, 10-01132, 12-02254 and 16-00896); by the Gobierno de Aragón (B35-Grupo Consolidado Biomedicina); and by the Fondo Europeo de Desarrollo Regional (FEDER) de la Unión Europea: “Una manera de hacer Europa”. The funding sources had no involvement in the study or chapter preparation.


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Patricia Gracia-García
    • 1
    • 2
    • 3
    • 4
    Email author
  • Elena Lobo
    • 3
    • 4
    • 5
  • Javier Santabárbara
    • 3
    • 4
    • 5
  • Concepción de la Cámara
    • 2
    • 3
    • 4
    • 6
  • Raúl López-Antón
    • 3
    • 4
    • 7
  1. 1.Psychiatry Service, Hospital Universitario Miguel ServetZaragozaSpain
  2. 2.Medicine DepartmentUniversity of ZaragozaZaragozaSpain
  3. 3.Instituto de Investigación Sanitaria de Aragón (ISS Aragón)ZaragozaSpain
  4. 4.Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Ministry of Science and InnovationMadridSpain
  5. 5.Preventive Medicine and Public Health DepartmentUniversity of ZaragozaZaragozaSpain
  6. 6.Psychiatry Service, Hospital Universitario Lozano BlesaZaragozaSpain
  7. 7.Psychology and Sociology DepartmentUniversity of ZaragozaZaragozaSpain

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