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Cardiovascular contributions to dementia: Examining sex differences and female‐specific factors
Madeline Wood Alexander, Jane Paterson, Zoe Arvanitakis, Sandra E. Black, Kaitlin Blackstone Casaletto, Marie K. Christakis, Gillian Einstein, Liisa A.M. Galea et al.. Alzheimer s & Dementia, 2025-08-01
Topic: Risk, prevention and care in population studies
Growing evidence underscores the importance of cardiovascular contributions to Alzheimer's disease and related dementias (AD/ADRD). While sex differences in cardiovascular disease (CVD) risk factors and outcomes are well established, the question of whether vascular contributions to AD/ADRD vary by sex has only recently garnered attention. In this narrative review, we discuss sex differences in conventional CVD risk factors (e.g., hypertension, dyslipidemia, diabetes), as well as underrecognized female-specific (e.g., menopause history, polycystic ovary syndrome, adverse pregnancy outcomes) and female-predominant (e.g., autoimmune conditions, breast cancer) CVD risk factors. Despite their relevance, these sex-specific considerations are rarely incorporated into current approaches to quantify CVD risk in AD/ADRD research. We offer recommendations to address these gaps and promote the use of sex-informed methods for studying cardiovascular contributions to AD/ADRD in women, which is essential for developing precision strategies to improve outcomes for all individuals at risk of dementia. HIGHLIGHTS: There are extensive sex differences in cardiovascular risk, dementia risk, and their interrelationships. Many cardiovascular risk factors confer greater risk for dementia in women than men. Existing approaches to quantifying cardiovascular risk often overlook sex differences and female-specific factors. Sex-informed approaches are essential for an accurate understanding of cardiovascular contributions to dementia.
Key findings
- We offer recommendations to address these gaps and promote the use of sex-informed methods for studying cardiovascular contributions to AD/ADRD in women, which is essential for developing precision strategies to improve outcomes for all individuals at risk of dementia.
- HIGHLIGHTS: There are extensive sex differences in cardiovascular risk, dementia risk, and their interrelationships.
- Many cardiovascular risk factors confer greater risk for dementia in women than men.
- Existing approaches to quantifying cardiovascular risk often overlook sex differences and female-specific factors.
- Sex-informed approaches are essential for an accurate understanding of cardiovascular contributions to dementia.
Why it matters
This review discusses sex differences in cardiovascular contributions to Alzheimer's and related dementias, noting that many cardiovascular risk factors confer greater dementia risk in women than men. It recommends using sex-informed methods in research, but does not test any treatment or prevention approach.
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Study details
- Study designnarrative review
- Evidence strengthLow
How this study scored 48/100
Published in a peer-reviewed journal. Scored zero for study design, sample size, effect reported, studied in people and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Alzheimer s & Dementia) |
| Journal's citation record | 2 / 4 | Alzheimer s & Dementia: journal h-index 228 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | Design recorded as “narrative review”, which our rubric does not rank (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 4 / 5 | 2025 — within 3 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 3 / 7 | Cited 19 times (OpenAlex, 2026-10-10) |
| Citations per year | 2 / 5 | 6.3 citations a year over 3 year(s) since 2025 |
| Impact for its field and year | 4 / 6 | Cited 12.1× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 2 / 6 | Cited by 4 other studies in this library |
| Still being cited | 2 / 4 | Cited 19 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 2 / 4 | Last-listed author Jennifer S. Rabin: h-index 34 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | University of Toronto: institution h-index 1,923 (OpenAlex) |
| Multi-centre collaboration | 3 / 3 | OpenAlex lists 13 institution(s) in 2 countries |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 40851413) |
| Free to read | 2 / 2 | Free to read |
| Total | 48 / 100 | — |
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Read the original
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Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record's author list ends in “et al.”, so not every author is named. Check the citation against the original before you use it.
APA 7th
Alexander, M. W., Paterson, J., Arvanitakis, Z., Black, S. E., Casaletto, K. B., Christakis, M. K., et al. (2025). Cardiovascular contributions to dementia: Examining sex differences and female‐specific factors. Alzheimer s & Dementia. https://doi.org/10.1002/alz.70610
Vancouver
Alexander MW, Paterson J, Arvanitakis Z, Black SE, Casaletto KB, Christakis MK, et al. Cardiovascular contributions to dementia: Examining sex differences and female‐specific factors. Alzheimer s & Dementia. 2025. doi:10.1002/alz.70610. PMID: 40851413.
BibTeX
@article{alexander2025-40851413,
author = {Alexander, Madeline Wood and Paterson, Jane and Arvanitakis, Zoe and Black, Sandra E. and Casaletto, Kaitlin Blackstone and Christakis, Marie K. and Einstein, Gillian and Galea, Liisa A.M. and others},
title = {{Cardiovascular contributions to dementia: Examining sex differences and female‐specific factors}},
journal = {Alzheimer s \& Dementia},
year = {2025},
doi = {10.1002/alz.70610},
pmid = {40851413},
url = {https://doi.org/10.1002/alz.70610}
}
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