A joint study of the Barcelonaβeta Brain Research Center (BBRC), our research center, and the foundation Women's Brain Foundation has revealed significant differences in willingness to participate in clinical trials for Alzheimer's prevention between men and women. Published in the scientific journal Alzheimer's Research & Therapy, the study highlights the need to adapt recruitment strategies to existing gender differences to ensure equitable representation in research.
One of the most relevant findings is that the single women with a higher educational level show a a lower willingness to undergo invasive procedures such as lumbar puncture. These results highlight the need to integrate the specific needs of women into the information provided about clinical trials, in addition to exploring less invasive alternatives, such as blood biomarkers.
With Alzheimer's disease accounting for between 60% and 80% of dementia cases and expected to exceed 150 million cases by 2050, it is critical to identify and address gender barriers to equitable participation in research.“Historically, women have been underrepresented in clinical trials across various fields of medicine, limiting our understanding of how diseases and treatments may differentially affect them.", says the Dr. Anna Brugulat, neuropsychologist and researcher at the BBRC and leader of the study.
Main conclusions of the study
The research team analysed the participation of more than 2,500 cognitively healthy individuals from the Alpha cohort, supported by the ”la Caixa” Foundation, to assess their willingness to undergo medical procedures such as MRIs, lumbar punctures, PET scans, and cognitive assessments. Authors suggest that increased education could translate into greater caution in evaluating the procedure. In addition, previous negative experiences, personal or known, such as the use of epidural anesthesia during childbirth, could reinforce this perception of risk. And also that being single could entail a more limited support network, which would make it difficult to seek help or post-procedure care, increasing the reluctance to participate.
Given these results, the Dr. Brugulat states that "it is critical to address women's specific concerns and provide clear and accessible information about the benefits and risks of participating in clinical trials. Furthermore, exploring less invasive alternatives, such as blood-based biomarkers, could foster greater equity in research."
Sociocultural factors influence the decision
Alzheimer's disease has a significantly greater impact on women, not only in prevalence but also in severity, which makes equitable inclusion in studies even more relevant. On a global scale, two out of three people who suffer from the disease are women, who also more frequently take on the role of caregivers for family members with dementia.
The study highlights that gender differences in participation are not exclusively due to biological factors, but are also influenced by sociocultural factors. For example, the women participating in the study tend to take on roles as family caregivers and they have educational levels, slightly lower compared to men, aspects that may influence their perception of clinical trials.
Study findings highlight the importance of designing more inclusive recruitment strategies that consider factors such as gender, marital status, and educational level. Promoting awareness campaigns and developing personalized approaches can also improve the representation of women in Alzheimer’s disease clinical trials, ensuring that research fairly reflects the reality of those living with the disease.
