Health
Men’s Brains Shrink Faster with Age, But Alzheimer’s Still Strikes Women More Often, Study Finds
Men experience faster brain shrinkage as they age than women, yet Alzheimer’s disease remains nearly twice as common in women, according to a new study that challenges long-held assumptions about the roots of the gender gap in dementia.
The research, published this week in the Proceedings of the National Academy of Sciences (PNAS), examined more than 12,000 brain scans from nearly 5,000 healthy individuals aged 17 to 95. The findings show that while men’s brains show a steeper rate of decline across several key regions, this does not explain why women are far more likely to develop Alzheimer’s disease.
According to the World Health Organization (WHO), around 57 million people were living with dementia in 2021, with nearly 10 million new cases recorded annually. Alzheimer’s disease — the most common form of dementia — disproportionately affects women, with one in five developing the disease by age 45, compared to one in ten men.
For decades, scientists have sought to determine whether structural differences in how male and female brains age could explain this disparity. However, the new study suggests otherwise.
Researchers found that men’s brains tend to shrink faster in multiple regions linked to memory, sensory processing, and movement. The postcentral cortex — the part of the brain that processes sensations such as touch and pain — declined by 2% per year in men, compared to 1.2% in women. Men also exhibited greater thinning in the cerebral cortex, particularly in regions tied to memory and visual recognition, such as the parahippocampal and fusiform areas.
Additionally, men showed more pronounced decline in subcortical structures including the putamen and caudate, which are critical for movement control. Women, by contrast, showed more fluid accumulation in the brain’s ventricles — a sign of normal ageing — but retained more structural integrity overall.
Despite this, women continue to face a far higher risk of Alzheimer’s disease. Experts say the reasons lie beyond structural brain changes, pointing instead to hormonal, genetic, and lifespan factors.
“Hormonal changes after menopause, vascular and immune differences, and genes like APOE ε4 all play a role,” said one of the study’s authors. “Women also live longer than men, which naturally increases their risk.”
Globally, women’s life expectancy is about five years longer than men’s — 73.8 years versus 68.4 years in 2021 — meaning more women live into the age range where Alzheimer’s risk is highest.
The findings underscore the complexity of Alzheimer’s and the need to explore biological and environmental factors beyond simple brain volume loss. As the researchers concluded, the key to understanding women’s greater vulnerability to dementia “will not be found in brain scans alone.”
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Uzbekistan to Launch Nationwide State Medical Insurance System in 2026
Uzbekistan will begin introducing a nationwide state medical insurance system from 2026, part of a broader overhaul of the country’s healthcare financing and service delivery. The reform will introduce digital referrals, a national health insurance fund, and a guaranteed package of essential medical services funded through the state budget. Officials say the changes aim to improve efficiency, expand access, and reduce informal payments.
“State health insurance is a social protection system designed to guarantee access to quality healthcare services,” said Zokhid Ermatov, executive director of the State Health Insurance Fund.
Discussions about state medical insurance in Uzbekistan began in 2017, but implementing such a system required years of preparation. The State Health Insurance Fund was formally established in December 2020, and pilot programmes launched in the Syrdarya region in 2021 tested new financing mechanisms, regulatory frameworks, and digital health systems. In November 2025, the Cabinet of Ministers approved regulations governing how medical care funded through the state budget will be provided in public and private medical institutions, with the rules set to come into force on January 1, 2026.
At the centre of the new model is stronger primary healthcare. Patients will first visit their assigned family clinic, where doctors provide consultations, prescribe tests, and determine whether specialist care is needed. If necessary, patients will receive an electronic referral to hospitals or specialists. Emergency and urgent care will remain available without referrals.
The reform introduces a patient-centred financing model, where healthcare providers are paid by the State Health Insurance Fund based on services delivered. Primary healthcare will be funded through capitation payments, while hospital treatment will follow case-based payments, a structure designed to improve efficiency and treatment outcomes.
A fully digital referral system will allow patients to choose hospitals from a list of institutions contracted with the State Health Insurance Fund using a government portal or mobile app. Referrals will remain valid for 60 days, and waiting lists and hospitalisations will be managed through a unified electronic health information system.
The insurance system guarantees essential healthcare services, including family doctor consultations, diagnostic tests, outpatient treatment, preventive screening, some medicines, hospital care, and certain rehabilitation services. Patients will not be charged additional fees for services included in the approved package.
Funding for the program will come primarily from the state budget, ensuring citizens do not pay direct insurance contributions. Priority access will be given to socially vulnerable groups, including children with disabilities, orphans, pensioners, pregnant women, unemployed citizens, and low-income families. The State Health Insurance Fund will allocate resources across regions to strengthen medical services and reduce inequalities.
International organisations have praised Uzbekistan’s approach, noting that general tax financing and universal coverage can improve financial protection and ensure predictable healthcare funding. Jessika Yin, Health Policy Adviser at the World Health Organization in Uzbekistan, said the reforms align with global trends toward universal health coverage.
If implemented successfully, Uzbekistan’s state medical insurance system could represent a major step toward universal healthcare, ensuring that people receive care without facing financial hardship.
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