Looking Ahead: health promotion topic

The topic I would like to focus on for my health promotion learning journey is women and Alzheimer’s disease: The hidden inequity in dementia risk.

What do you know about this health promotion topic to date?

The number of Canadians living with dementia, including Alzheimer’s disease (AD), is climbing rapidly — and women are disproportionately affected. A mix of biological, hormonal, and social factors places women at significantly higher risk as they age. In 2020, women accounted for roughly 61.8 per cent of all people living with dementia in Canada. By 2050, forecasts indicate that more than one million women in Canada will be living with dementia. These numbers are staggering and present a critical health issue for woman across the lifespan (Alzheimer’s Society, n.d.).

Women in Canada continue to outlive men, with data from 2023 showing an average life expectancy of 84 years compared to 79.6 years for men. Because age is one of the strongest predictors of dementia and AD, women’s longer lifespans place them at a heightened risk of cognitive decline as they grow older (Miller, 2026).

Furthermore, women are more likely to be caregivers of those living with AD. In the US, more than three in five unpaid Alzheimer’s caregivers are women. This can impact multiple generations and contribute to adverse consequences such as higher levels of stress and depression (Alzheimer’s Association, n.d.).

What are my own personal learning goals?

I endeavor to explore the health disparities in AD to uncover the existing social and structural inequities impacting women.

I would like to identify the modifiable risk factors for dementia - 40% of dementia cases worldwide could be preventable. A 2020 report of the Lancet Commission found that 12 modifiable risk factors could account for that 40% (Livingston et al., 2020).

What am I most excited to learn?

I look forward to diving into the evidence supporting health promotion strategies that address the inequity in AD risk for women. The Population Health Promotion (PHP) model is particularly relevant to understanding women’s heightened risk of developing AD. It illustrates how population‑level health approaches and health promotion strategies intersect, showing that meaningful action must address the full range of health determinants — not just individual behaviours or clinical factors. When applied to women and AD, the PHP model can illuminate how biological changes, such as hormonal shifts during menopause, interact with social and environmental conditions, including caregiving roles and income disparities. This framework reinforces the need for upstream, equity‑focused strategies that support women’s brain health across the lifespan (Government of Canada, 2001).

Anything make me nervous?

Something that is on my mind is whether I should broaden my topic to address women of different ethnicities and race, to uncover health inequities within these groups which may contribute to higher incidence of AD.

Looking ahead, what will be challenging as I pursue my chosen health promotion topic/project?

Like many practitioners, I am used to working within a clinical, treatment‑focused model grounded in person‑centered interventions. Moving forward, it will be essential to broaden my lens beyond individual outcomes and toward upstream approaches. This shift requires coordinating population‑level health strategies that account for the powerful influence of physical, social and structural environments.

What do I most want to learn more about, and why?

My interest in women’s hormone health has grown significantly since beginning my perimenopause journey. The recent passing of my aunt from AD has deepened my concern for women’s brain health, and I have begun to explore the biological and social factors that shape women’s risk across the lifespan. This exploration has highlighted how deeply interconnected hormones, aging, and structural determinants are in influencing cognitive outcomes (Silva et al., 2024).

Biology plays a role beyond longevity. Women carry a higher genetic susceptibility to Alzheimer’s, and the hormonal shifts of menopause, particularly the steep drop in estrogen, can accelerate neuro‑inflammatory processes that contribute to neuronal damage and cell death (Kempuraj et al, 2016). Research increasingly points to a link between menopause and a greater likelihood of developing AD, highlighting the important role that declining estrogen levels may play in its onset. This interconnection is something I hope to better understand through this learning journey.

References

Alzheimer’s Association. (n.d.). Women and Alzheimer’s. https://www.alz.org/alzheimers-dementia/what-is-alzheimers/women-and-alzheimer-s

Alzheimer’s Society (n.d.). Dementia numbers in Canada. https://alzheimer.ca/en/about-dementia/what-dementia/dementia-numbers-canada#:~:text=The%20number%20of%20people%20living,living%20with%20dementia%20by%202050.

Government of Canada. (2001). Population Health Promotion: An Integrated Model of Population Health and Health Promotion https://www.canada.ca/en/public-health/services/health-promotion/population-health/population-health-promotion-integrated-model-population-health-health-promotion/developing-population-health-promotion-model.html

Kempuraj, D., Thangavel, R., Natteru, P. A., Selvakumar, G. P., Saeed, D., Zahoor, H., Zaheer, S., Iyer, S. S., & Zaheer, A. (2016). Neuroinflammation induces neurodegeneration. Journal of Neurology, Neurosurgery and Spine, 1(1), 1003. https://pmc.ncbi.nlm.nih.gov/articles/PMC5260818/#:~:text=Neuroinflammation%20is%20initially%20a%20protective,affected%20regions%20in%20the%20brain.

Livingston, G., Huntley, J., Sommerlad, A., Ames, D., Ballard, C., Banerjee, S., Brayne, C., Burns, A., Cohen-Mansfield, J., Cooper, C., Costafreda, S.G., Dias, A., Fox, N., Gitlin, L.N., Howard, R., Kales, H.C., Kivimäki, M., Larson, E.B., Ogunniyi, A., Orgeta, A., Ritchie, K., Rockwood, K., Sampson, E.L., Samus, Q., Schneider, L.S., Selbæk, G., Teri, L. & Mukadam, N. (2020). Dementia prevention, intervention, and care: 2020 report of the Lancet Commission. The Lancet Commissions, 396(10248), 413 – 446. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30367-6/fulltext

Miller, M. (2026, January 21). Women face a higher risk of Alzheimer’s and dementia than men — and early childhood can play a factor. Yahoo Life. https://ca.style.yahoo.com/women-face-a-higher-risk-of-alzheimers-and-dementia-than-men--and-early-childhood-can-play-a-factor-190004673.html?guce_referrer=aHR0cHM6Ly93d3cueWFob28uY29tL2F1dGhvci9taXJhLW1pbGxlci8&guce_referrer_sig=AQAAAE9yw1PTPoR98l49cnHLIVUl0wMyRyh42f1OVwIIHlQVDZYebHeHvOSDoVQW-GnsPxazLRYh4jzOURhYlG-PVvMg5lX22nY7Cg9kRVVmeXLZ-JZOAd6UekL8SIeMlmuhoM7Q1LAckLqoYedAP6yWcgpghZLlaNa2QURaymCyV-mQ&guccounter=2

Silva, G. B., Pascucci, J.A., Karim, H., Kaur, G., Olivas Lerma, R., Mann, A. K., Gnanasekaran, S., & Thomas Garcia, K. D. (2024). Influence of the onset of menopause on the risk of developing Alzheimer's disease. Cureus, 16(9), e69124. https://doi.org/10.7759/cureus.69124