CHAPTER 24: Converging Issues in Heart Disease, Stroke, and Alzheimer’s Disease in Women

Introduction Leading causes of death in U.S. women over 65: – Cardiovascular disease (first) – Stroke (third) – Alzheimer’s disease (fifth) Examining them together may lead to greater understanding of prevention and treatment strategies.

Commonalities in Heart Disease, Stroke, and Alzheimer’s Disease Sex Difference Comparisons – Generally occur at later ages in women than men – Risk of hypertension

Commonalities in Heart Disease, Stroke, and Alzheimer’s Disease Ethnic Comparisons – For heart disease and stroke, Black women have highest prevalence compared to White women. – For AD, prevalences among ethnic groups are not as clear.

Commonalities in Heart Disease, Stroke, and Alzheimer’s Disease Psychosocial Risk Factors – Stress – Depression – Other psychological factors – Hormonal factors

Commonalities in Heart Disease, Stroke, and Alzheimer’s Disease Hormone Therapy Genetic Factors – Specifically relevant for AD – However, genes can interact with estrogen, which can play a role in heart disease and stroke.

Aftermath, Disability, and Course Women are more likely to die, suffer more disability, or experience more impairments than men. Reasons for poor outcomes in women are likely multifactorial.

Aftermath, Disability, and Course Lack of Education and Awareness as Contributors to Disability – Knowledge of signs and symptoms – Obtaining treatment at the appropriate time – Personal/caregiver awareness

Aftermath, Disability, and Course Process of Aging and Age of Onset – Older age of onset – More comorbid conditions – Less likely to recover as well

Aftermath, Disability, and Course Emotional Psychosocial Issues: Focus on Depression – Depression is more prevalent in women than in men. Aftermath and Caregiving – Caregiver burden is associated with poorer quality of life and early nursing home placement.

Conclusions and Future Directions More research is needed to understand the similarities and differences in these disorders of aging in women. Need exists for increased cultural competency. Cross-disorder research will determine common factors.