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2022 Alzheimer's Association Research Fellowship to Promote Diversity (AARF-D)

Influence of Structural Sexism and Racism on AD Risk

How may early-life exposure to societal discrimination impact a woman’s risk for dementia?

Justina Avila-Rieger, Ph.D.
Columbia University
New York, NY - United States


According to the 2022 Alzheimer’s Association Facts and Figures report, almost two-thirds of Americans with Alzheimer’s are women. While this higher prevalence may be due, in part, to women’s longer life expectancy, emerging science tells us there are other contributors as well. This could include structural sexism. Structural sexism refers to the ways that society discriminates against women and limits their ability to receive adequate housing, education, employment, earnings and health care. For Black women in America, the problems of structural sexism are compounded by structural racism. Structural racism involves health and socioeconomic disparities that are rooted in the history of discrimination against Black individuals and other people of color in the United States, not only during interpersonal interactions, but also as enshrined the systems and other institutions. 

Structural sexism and racism have been shown to impact different aspects of women’s overall health, but their role in dementia risk remains unclear.  In initial research, Dr. Justina Avila-Rieger and colleagues analyzed  data from an urban study of aging called the Washington Heights-Inwood Columbia Aging Project (WHICAP). Their analysis found that Black and White women who experienced structural sexism early in life experienced greater than normal losses of memory and language skills as they aged. The researchers also found that structural sexism had a greater impact on memory loss among White women than it did among Black women.

Research Plan

Dr. Avila-Rieger’s team will now conduct a larger study assessing the role of structural racism and sexism in women’s brain health. They will analyze data from about 12,000 women in the WHICAP study and two other studies of aging. First, they will explore how early-life exposure to sexism and racism alters aspects of brain structure and function over time – aspects such as memory loss, brain cell degeneration and loss of white matter (the primary wiring system in the brain that is used by nerve cells to communicate with one another). Second, they will assess whether brain inflammation, a key hallmark of Alzheimer’s and other brain changes, may be associated with the biological mechanisms of how structural racism and sexism impact brain health in aging White and Black women. 


Dr. Avila-Rieger’s study will shed new light on the complex roles of discrimination and other social factors in a woman’s risk for dementia. It may also lead to novel health and public policy strategies for reducing dementia prevalence among women.

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