Dr. Jane Salmon & Dr. Fanny Elahi on the Future of Women’s Health

Alzheimer's disease. You may be surprised, as I was, to learn that two out of three new Alzheimer's patients are women, and women bear a double burden, comprising more than six of Alzheimer's and dementia caregivers. Yet, the outsized impact of Alzheimer's and other neurological diseases on women remains under examined, and women scientists continue to be underrepresented and underfunded. Putting a women's lens on this disease is essential if we want to improve the lives of both women and men.

I sat down at the Metropolitan Museum of Art with Dr Jane Salomon of Wild Cornell and Dr Fannie Allahi of the UCSF Memory and Aging Center. These two scientists are working tirelessly to make huge breakthroughs in women's health. Listen to our conversation to learn why adding more women to medical research is urgent for everyone, what's at stake if we don't, and the empirical reason why you just might want your next doctor to be a woman, and

stick around after the conversation for our top takeaways. So I want to welcome Dr Jane Sollman, Associate Dean at wild Cornell and Professor of Medicine. You're going to hear why we're so honored to have her today, and of course Dr Fannie Allahy, m D, pH d and Assistant

Professor at UCSF. Thank you both for being here. So we a lot today about women in tech and girls in tech, and we thought it was really important to talk to women scientists who have been at the forefront and are at the forefront of solving some of the most important issues for women's health. So Jane, let's start with you. Uh, tell us a little about your work in lupus and how and what you discovered about lupas

and pregnancy. Lupas is a disease where the immune system, which really evolved to protect us against microbes, turns against the body and attacks organs and nent of patients with lupus or women, and most women developed disease in their twenties. These girls or young women were told never to become pregnant because they or their babies could die, and that guidance was really based on limited information. So I spent a good deal of my career trying to determine whether

or not this was true for all lupas patients. My team studied hundreds of women with lupus, and what we learned was the pregnant see complications severe ones in patients are extremely uncommon, and we could identify the limited subset of patients who would have these complications. We also discovered the biology around pregnancy complications in lupus, and we're now having a promising treatment trial funded by the NIH to

see if we can protect these women from complications. And what's particularly interesting is the possibility that what we're going to learn from this trial applies to all women, not just women with lupus. There are very there's no treatments for preclamsy of taxinia pregnancy, but we may be able

to develop a treatment. Kind of the cost of morbidity in pregnancy is expensive to the society and to the family, and there's very little research on diseases of pregnancy, and that's really what I've committed my career to and hopefully we'll be able to change it. Thank you. Not Fanny. We saw these incredible statistics about UM women in Alzheimer's

and I've been very taken by the numbers. UM, So can you tell us, well, obviously you study the conditions that could lead to a cure for Alzheimer's, and I'm amazed by your research. Why is this also a women's issue and given your experience, why is it important to look at health vilens of women and in particular women's scientists. Thank you, Kim. I think the statistics are really striking.

It's UM. Alzheimer's and your degenative disorders are humanities issue and especially women's issue, and numbers don't lie and they're surprising, and so I really think that we have to get at the route causes and what we will discover relating to women's risk of increased risk of Alzheimer's could potentially actually translate to all sorts of Alzheimer's. So the first step is to have a precision medicine approach to understand what it is about a human being that predisposes them

to new generation. What are the specific factors as opposed to just blanket age or gender, sex, ethnicity. And so we're working on bio markers. You know, we're looking at people's retina, we're looking at their brain structures, were taking blood and looking at proteins and urn a different molecules in their blood. To to have a more to stop guessing and to have a more precise idea of risk um and and and the history um of of change

in a human being that then predisposes them. One of one of the facts, um, is that Alzheimer's really starts decades before it actually presents in the clinic. And if we stand a chance, it ought to be early. And so we need to intervene early, and we need to detect early in order to intervene early. I was taken um by um some of the research point and what you told me about sort of hormones and this sort of failure to look at the disease through the lens

of women in this when the statistics are staggering. Can you just tell us a little bit of that, um, So, as a clinician scientist, I do science and I also see patients, and I think the scientists and me is driven by data, and the clinician has given me the privilege to observe and to interact with women. Um So one of the most striking um occurrences has been seeing perimenopausal women walk into my clinic and report cognitive changes that have been dismissed by so many other clinicians before me.

And maybe the first time I thought, you know, maybe this is subjective. The second time, it's harder to think that. The third, and the fourth, and and the problem is that our tests are not sensitive enough to detect those changes, and so there are no objective measures to say that you're at dress. We just have to go and believe them and then set up experiments and test these hypotheses.

So that's what I want to do in the future, and really dig into these early quote unquote subjective changes that women are reporting and tried to find objective ways to measure these in a sensitive manner. Jane, you know, one of the statistics that I had read, which I found was amazing. Maybe you got some of you read

it in New York Times recently. It says that actually patients there, I think they studied uh is a fifty eight thousand, fifty eight thousand patients in emergency rooms, and they found that patients who were seen by women doctors actually had better survival rates. You know, this is the reason to really pour women in science, just for a selfish reason. But Jane, look, can we talk about this because you are the highest ranking one of the highest

ranking scientists frankly at wild Cornell. You've been a true leader in this field. I was really taken when we first met about how you made the business case for your research, and similar to what Fatty was just saying about how she's trying to make the case right now for more funding because we know that women in Alzheimer's chronically underfunded. Women's health it's chronically underfunded. You've been a

true leader in this field. You have been able to make that case, um, and you've also been able to support other women's scientists. But yet we're still facing this chronic gap in the senior ranks of the scientific community. And why is that? And what do you see? You know, I think women see medicine differently. You heard that from Fanny. Women ask questions differently, they analyzed data differently, and they

asked different questions. In the nineteen eighties, the only mention of women's heart disease in a major society meeting of cardiologists was how to deal with your husband's heart attack? H we we we've become we we've come really a long way. Yeah so so so I think you know, we've come a long way, but um, we have a long way to go. Uh. When I was a medical student,

there were very few women. There were almost no women faculty. Um. And I was introduced to a pay a little I took care of a ten year old boy, and I was introduced to his mother as the doctor who's a nurse. Uh. And I don't think that was rare uh in those days. And I think we we we still see happens. We still we still see that sometimes. And so now of medical students, i'd say for the past twenty years or women, and as of seventeen in American medical schools, of the

assistant professors or women. But when you start working your way up associate professors, it's only thirty six percent, and full professors is only. This isn't really a pipeline issue. As you've heard before. It takes longer for women to be promoted, and they're much less likely to be put up by their cheers for promotion than men in their departments. It's an issue that academic medicine recognizes and we're trying to address. But it's really similar to what you see

uh in all fields. In order to get the right multidimensional look at basic and clinical questions, you have to

have women physicians. They listen better. Then you need women mentors, women leaders to inspire other women to follow you so that women's diseases can be addressed and the sensitivity that Kim talked about and people will live longer if their docs or women I mean, if that not a simple business case coming so, so if any we talked about this as well, about why this lens of women makes a difference, why questions haven't been raised in the past, and you mentioned to me that you know, we probably

wouldn't be lagging as far behind maybe if we'd ask these questions sooner. And I think that you know your research is showing some pretty remarkable opportunities, but what's the problem and why are we still seeing this lag there? So I think the Citus it's that Jane Um mentioned with respect to women advancing in their career in science and medicine are really striking, and we need to learn from other industries and get at the root causes. Why

is it that that's occurring? I feel that UM women are given opportunities, but then on a day to day basis, maybe the support is not there. And obviously the role models are far and fewer in between than men because it's a new, relatively new field for a women UM.

And why are we lagging behind on discoveries that really specifically to women's conditions is probably also because in medicine you need curiosity and intellectual drive, but at the end of it you also need passion because it's a long road, it's difficult, there are lots of failures, and you need to have that sort of internal stimulus that constantly drives

you UM. You need to to be touched by the question, and I can't say that men are not touched by women's questions, but it's probably it's more probable that women

will be UM. And so we really need, just for the sake of diversity of questions and importance of the questions, that I asked more women UM trained UM and credential to do that well and I think, uh again, I've spent a lot of time with these women over the last time preparing for this, and and Jane has been a mentor to so many and she's told us so much about what she does to mentor women. Um and what we've decided to try to do together this year is to try to focus a little bit more on

women's scientists. I think that women's science is chronically underfunded. I've understood this now from both of them, and I think you know what Fanny's work is doing to really prevent this epidemic. Though. If there is the possibility of a cure, if there is the possibility of ending PROCLAIMSIA or getting more research about this, we need to do it.

But it's underfunded. So I would ask all of you again on this connect point concept, to go home to think about your institutions, your organization, sations, the foundations you're involved with, and let's see if we can't get some of the science funded. Thank you both. Stay tuned for our takeaways after this break. That was truly an enlightening conversation.

So many families are touched by Alzheimer's and I was amazed to learn from Dr ALLAHI that just like breast cancer, early detection is within reach and could save lives if women scientists and their research could just get the support they need. To learn more about Dr Allahi's work at the UCSF Memory and Aging Center and how to support the Women in Alzheimer's Research Fund, go to Seneca Women dot com, and to learn about Dr Jane Solomon's work on lupus, go to wild Doc Cornell dot e du

Our top takeaways. First, when it comes to medical conditions, we need to recognize that women's biology matters too. Women may have different symptoms, different reactions to medication, and different responses to treatment than men do. We need to ensure that the medical community acknowledges these differences so that women are properly diagnosed and treated. Second, it's time to demand that women are equally represented in clinical trials and that

research was taken to account sex and gender differences. Will know more about human health when women's health and disease risk are better understood. Finally, it's imperative that more funding and support flow to women's scientists and clinicians. A women's lens matters when you have diverse scientists who get more innovation as well as studies with a broader perspective and

a more thorough understanding of patients. By failing to support women's scientists, we are literally holding back innovation and the chance to find cures for disease and improve health for everyone. For me, supporting women's scientists may be one of the most important steps we can take right now out in advancing women and improving lives. Let's each try to spread the word and make a contribution in any way we can. Together,

we can do this. You're listening to Seneca Women Conversations on Power and Purpose, brought to you by the Seneca Women podcast Network and I Heart Radio with support from founding partner PNGNG. Listen to Seneca Women Conversations on Power and Purpose on the I Heart Radio app, Apple Podcasts, or wherever you get your podcasts, and please support this

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