Ensuring Sex & Gender Representation in Dementia Research

The Women, Sex, Gender, and Dementia (WSGD) cross-cutting program, led by Dr. Gillian Einstein, Wilfred and Joyce Posluns Chair in Women’s Brain Health and Aging at the University of Toronto, has its eye across the entire Canadian Consortium on Neurodegeneration in Aging (CCNA), helping teams bring the sex and gender lens to all of their dementia research.

In spite of the higher rates and incidence of Alzheimer’s disease in women, much of the basic research that underpins our current understanding of the disease is from studies on male mice. In addition, many clinical trials, while they include women and men, cancel out any sex effects by controlling for sex.

Despite a historical reluctance to prioritize sex and gender (S&G) considerations, “most of the time when somebody separates their analysis by sex, they see these differences,” says Dr. Einstein. If they do not, that is important to know as well, she adds.

To ensure proper representation of female sex and gender considerations across the CCNA, Dr. Einstein is working with a team of S&G Champions who serve as advocates on each team. The champions come together regularly to compare notes and assess different methods of promoting S&G considerations, adding to the collective understanding of the issue in Canadian research.

Dr. Einstein also reviews every CCNA produced paper to ensure it includes S&G considerations. In addition, one of the goals of the WSGD program is to provide extra funds to the teams to ensure representative study populations can be accessed by researchers —for example, by funding the use of female mouse colonies, which are typically more expensive to use.

“The role of the WSGD cross-cutting program is really to ensure that every team and platform is thinking about sex and gender in the research, and building up a research climate in which people feel comfortable doing that,” says Dr. Einstein.

According to Dr. Einstein, understanding these implications in dementia is crucial, because it gives us one more tool in providing individualized, effective care for Canadians suffering from the disease. “Sex and gender is just one part of that,” she says. “But it’s an overlooked part. Women are people who have been overlooked in this research.”

She hopes that this Brain Canada-funded push will help influence the broader Canadian research landscape. Dr. Chertkow agrees, noting that he hopes the WSGD program can become a model internationally. “This team ensures Canada is ahead of the curve when it comes to S&G considerations,” he says.

The work aligns with Brain Canada’s new Sex, Gender & Diversity and Inclusion considerations, which was introduced in early 2021 and outlined our commitment to ensuring S&G is included in all Brain Canada research programs going forward.