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The gendered dynamics of Alzheimer’s disease

Published 30 January 2020

Antonella Santucchione Chadha, Global Lead for Alzheimer's Disease Partnership at Roche, talks about her journey and her longstanding passion to better understand the relationship between sex, gender and brain disorders.

Can you tell us a little bit about yourself and what shaped you?
For me the biggest lesson in life has always been the people. I had the privilege to grow up in an extremely diverse environment. I was surrounded by very humble people, some of them illiterate as well as prestigious ones, like politicians, professors and so on. I learned from all of them. Later in life, this helped me to communicate and find a common language with my patients. I worked in psychiatry, so you dealt with all kinds of people – from the schizophrenic man living on the street to the most sophisticated elderly lady with delusions.

You are the co-founder and CEO of the non-profit organisation Women’s Brain Project – how did this come about?
I had been working in the field of Alzheimer’s disease (AD) for a long time already. It became increasingly clear to me and my colleagues at the Women’s Brain Project that women were more often affected by AD, and that their disease progression was also faster than in men. We started to collect data, and finally published an article in the Nature Neurology Review.

This was the starting point. BBC called us and neuroscientists got interested in the topic. We were also challenged by colleagues in the AD field but this made us even stronger. I’m very proud of what the team achieved. Our goal is to generate evidences and stimulate a global discussion on the impact of gender and sex in regard to brain and mental disease.

Antonella Santucchione Chadha
Antonella Santucchione Chadha, Global Lead for Alzheimer's Disease Partnership at Roche

What is the impact?
It’s obvious that men and women are affected differently by different diseases. For instance, depression, migraine, anxiety or AD affect twice as many women. It’s not clear yet whether this is due to biological and/or social factors. We also know that many of the most prescribed drugs such as Cymbalta, Abilify or Nexium only work in a fraction of patients. It is only logical that some of these differences, in terms of efficacy, are related to sex and gender, but we do not adequately take them into account.

We need a representative population in clinical trials. Right now, clinical trial designs are old-fashioned, and women are often underrepresented. Even in animal experiments, especially in neuroscience, we mainly use male mice or sex and gender differences are not reported!

What does this underrepresentation mean for women?
According to a report from the United States General Accounting Office, 8 drugs out of 10 which were withdrawn from the market, were withdrawn because of side effects in women: this is leading to a huge burden for patients, drug developers and health care systems.

We need to better understand this so that drugs can be better developed and precision medicine becomes a reality. This is the only way to make health systems sustainable.

You’ve been working in Alzheimer’s for many years. Why did you choose this field?
I love challenges. I never chose the easy way. For example, medicine was not my inclination, after all it consists of a lot of tedious mnemonic studying. But I wanted to find out if I could make it. It was also very male-dominated in Italy – and everywhere else I fear – at the time, so I wanted to prove that I could be among them and make a difference. At heart I am a dreamer, and that made me stay with Alzheimer’s. You need a lot of belief to continue doing what you do in spite of all the setbacks. If you don’t have that strong motivation to make a difference, you don’t stay in this field.

You have a demanding job, your NGO, a family with two young sons. Where do you get your energy?
First of all, you have to have the right partner and colleagues who support you. For me, what I do is fun, otherwise I wouldn’t do it. That doesn’t mean I don’t sacrifice a lot.

On a personal level I went through a lot of things. You can decide: either you let yourself be absorbed by the sadness that life can hold, or you try to make the best of it and transform it into wisdom. That was my way out. My drive also comes from the people I interact with. I choose people who give me energy, and I am lucky to have a diverse spectrum of friends. It is so important to have role models from different phases of life who can teach you how to live and age wisely.

Do you have advice for women in particular?
One of the most important people in my life was my father. He advised me to always choose, rather than being chosen. Shape your life, don’t let things just happen to you. Other advice I have for women: Never feel inferior to anyone, and don’t think you have to act like a man! You can’t always be the most perfect, the most beautiful. We need to accept ourselves in our femininity and vulnerability and that is what makes us resilient.

Antonella Santucchione Chadha is Global Lead for Alzheimer's Disease Partnership at Roche. She was awarded “Woman of the Year 2019” by the Swiss Women in Business magazine. This award reflects her tireless work in solving the puzzles related to Alzheimer’s and other psychiatric diseases, as well as being the co-founder and CEO of the Women’s Brain Project.

Tags: People, Society, Neuroscience, Alzheimer's disease, We are Roche