The Durk Pearson & Sandy Shaw®
Life Extension NewsTM
Volume 18 No. 7 • November 2015

In the News: Women’s Dementia Worsens Faster Than Men’s

So says a headline in the July 22, 2015 The Wall Street Journal. According to the study (398 subjects who participated in the Alzheimer’s Disease Neuroimaging Initiative), women’s cognitive decline took place about twice as fast as men’s. The good news is that it is very likely, based on scientific studies showing that women need more choline than men do (Fischer, 2007), and that, as choline has been identified as a nutrient important to cognition (Poly, 2011), a deficiency of choline is one cause of this vulnerability to dementia in women. Not only does estrogen play an important role in the cholinergic nervous system (Fischer, 2007, Craig, 2010)—estrogen declines rapidly following menopause—it is known that in older people, choline is taken up less effectively into the brain (Cohen, 1995). In addition, women are much more susceptible to autoimmune diseases than men are and the cholinergic nervous system is a major antiinflammatory system (Tracey, 2007).

Add it all up and the evidence points to a need for additional choline in older women. The amount of choline recommended by the Institute of Medicine (IOM) for non-pregnant women, 425 mg a day, is (in our judgment) too low to supply adequate amounts of choline to older women when you consider the reduced ability to transport choline into the brain, the loss of estrogen, and also the variation dietary composition (van Wijk, 2012).

Choline consumption, genetic and epigenetic differences in the ability to absorb choline from the diet, get it into the brain, and then convert it to phosphatidylcholine (via biochemical pathways) varies between individuals suggesting that the amount that may be adequate for much of the population per the IOM recommendation may not be adequate for YOU. Note that human nutrition experiments are usually performed on young healthy college students, not on elderly people.

In short, choline is a major nutrient for keeping your cognitive function in good condition, as you get older. Durk takes 2 grams a day of choline in the form of choline dihydrogen citrate. Sandy is now taking CDP-choline, a form of choline that is a step closer in the synthesis of phosphatidylcholine (Carter, 2008) (a defect in this synthesis is now believed to be a major cause of Alzheimer’s disease) and has recently been identified as being epigenetically tagged by the cytidine diphosphate and, hence, may have some benefits over choline alone in the complex use of choline in the function of the cholinergic nervous system. She also takes 1 gram of choline a day as choline dihydrogen citrate in our sugar-free choline formulation.


  • Carter, Demizieux, Campenot, et al. Phosphatidylcholine biosynthesis via CTP:phosphocholine cytidylyltransferase beta2 facilitates neurite outgrowth and branching. J Biol Chem. 283(1):202-12 (2008).
  • Cohen, Renshaw, Stoll, et al. Decreased brain choline uptake in older adults. An in vivo proton magnetic resonance spectroscopy study. JAMA. 274(11):902-7 (1995).
  • Craig, Brammer, et al. The interactive effect of acute ovarian suppression and the cholinergic system on visuospatial working memory in young women. Psychoneuroendocrinology. 35:987-1000 (2010).
  • Fischer et al. Sex and menopausal status influence human dietary requirements for the nutrient choline. Am J Clin Nutr. 85(5):1275-85 (2007).
  • Poly, Massaro, et al. The relation of dietary choline to cognitive performance and white-matter hyperintensity in the Framingham Offspring Cohort. Am J Clin Nutr. 94:1584-91 (2011).
  • Tracey. Physiology and immunology of the cholinergic antiinflammatory pathway. J Clin Invest. 117(2):289-96 (2007).
  • van Wijk, Watkins, et al. Plasma choline concentration varies with different dietary levels of vitamins B6, B12 and folic acid in rats maintained on choline-adequate diets. Br J Nutr. 107:1408-12 (2012).

Featured Product

  • Learn more about Choline benefits and implementation strategies.

Ingredients in this Article

FREE Subscription

  • You're just getting started! We have published thousands of scientific health articles. Stay updated and maintain your health.

    It's free to your e-mail inbox and you can unsubscribe at any time.
    Loading Indicator