Women account for nearly twice the Alzheimer's prevalence seen among men, and early signs can stay subtle for years. Mercè Boada explains why diagnosis and new treatments are changing the field.
Researchers no longer see Alzheimer's disease as an unavoidable part of ageing. The illness can start changing the brain up to two decades before severe dementia appears. That long window now drives the search for earlier diagnosis and treatments that can change the disease itself.
Mercè Boada, a neurologist and co-founder of Ace Alzheimer Center Barcelona, says research has reached one of its strongest points. Scientists are testing treatments that target abnormal beta-amyloid and tau proteins. They are also studying ways to control neuroinflammation and use albumin plasma exchange to remove toxic substances from the bloodstream.
This does not mean every treatment is available to patients in Spain. It does mark a shift away from treating symptoms alone. Researchers are now targeting the biological mechanisms behind the disease. An IQVIA industry review describes anti-amyloid monoclonal antibodies as the first disease-modifying therapies for Alzheimer's. Lecanemab and donanemab can slow cognitive decline, but they are not cures.
On 1 May 2026, Health Canada approved donanemab for people with mild cognitive impairment or early Alzheimer’s disease, making it the country’s second disease-modifying Alzheimer’s treatment.
The gender gap makes the issue more urgent.
Women account for around 70% of people affected by Alzheimer's and face almost twice the prevalence recorded among men. Longer female life expectancy explains part of the gap because age is the main risk factor for dementia.
Boada also points to biological and hormonal factors. Oestrogens help protect brain tissue, support blood flow and regulate neuronal plasticity. The loss of oestrogen during menopause removes part of those repair mechanisms. Proteomic studies have found sex-related differences in cerebrospinal fluid and plasma linked to greater vulnerability to neurodegeneration.
The exact share of women varies by country and source. Reports put it at 63% of diagnosed cases in Peru during January-August 2025 and 72.2% among affected people in the Canary Islands.
The burden does not end with the diagnosis.
A 2026 Sanitas survey in Spain found that 47.7% of respondents had at some point cared for a person with Alzheimer’s or another form of dementia. The figure underlines how widely the consequences of the disease extend beyond the patient and into families and communities.
Alzheimer's changes the daily life of entire families. Almost 80% of primary carers come from the family, with wives and daughters making up most of that group. Two out of every three carers are women. Many reduce their working hours, leave employment or give up studies and social activities.
The health cost can include overload, anxiety, depressive symptoms and sustained stress. Boada says psychological support, practical training and Carer Classrooms should be treated as a healthcare and social priority.
Recent data support that concern. In Australia, more than eight in ten surveyed dementia carers described themselves as primary carers, while about half spent at least 40 hours a week on care. Australian Institute of Health and Welfare data also indicate that more than 70% of female unpaid carers feel overwhelmed. An Italian ANSA report found that more than half of carers spent over 12 hours a day providing care, while only 20.1% had sought professional support.
Early recognition remains the most immediate step families can take. Mild Cognitive Impairment affects 30% of people over 65 in Spain and can progress to dementia, including Alzheimer's disease. Warning signs include trouble remembering dates, forgetting familiar names, losing the thread of conversations and noticeable changes in behaviour.
The "Pequeñas Lagunas" initiative from Ace Alzheimer and Danone Nutricia aims to encourage early detection through pharmacies. It links the warning signs to situations people may recognise in everyday life. Early diagnosis matters even more because current disease-modifying therapies are intended for mild cognitive impairment or early dementia, not for the later stages of the disease.
Boada says a delayed diagnosis can take away the chance to make decisions while people remain independent. In Europe, the gap between the first memory complaint and diagnosis can still last three to four years.
She is calling for more public investment and closer coordination between primary care and specialist units. She also wants a political commitment that matches Alzheimer's social impact.
The policy question is tied to the wider pressure on health systems to decide where resources should go, an issue also examined in an earlier Europe analysis. Alzheimer's care has clear practical priorities. Diagnostic delays need to shrink. Women carrying the unpaid workload need support. Promising therapies must be assessed alongside reliable biomarkers.
The regulatory timeline shows that this is no longer only a research ambition. The UK's Medicines and Healthcare products Regulatory Agency licensed lecanemab and donanemab in 2024 for early Alzheimer's disease. NICE was considering their wider use in 2026.
Blood-based biomarkers could soon help detect brain changes through a simple plasma test. They could also support more precise treatment decisions. Spain is not yet commercialising the monoclonal antibodies intended for initial stages, but the research pipeline now includes several different approaches rather than one experimental route.
New ways to deliver treatment are also emerging. Biogen and Eisai reported on 16 September 2026 that the subcutaneous LEQEMBI Pen had been approved in Japan for early Alzheimer's disease. Subcutaneous use had already received approval in the United States in July and China in September.
That makes early medical consultation more valuable. Boada's message is direct: Alzheimer's should be confronted before autonomy is lost. Scientific progress will matter only if families and public services can reach it in time.
