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REVIEW article

Front. Hum. Neurosci.

Sec. Brain Health and Clinical Neuroscience

This article is part of the Research TopicWomen in Aging Neuroscience: new perspectives and challengesView all 4 articles

Loneliness as a Sex-Specific Risk Factor for Cognitive Aging

Provisionally accepted
  • 1School of Medicine and Health Sciences, George Washington University, Washington, D.C., United States
  • 2Harvard University Extension School, Cambridge, United States

The final, formatted version of the article will be published soon.

Loneliness has emerged as a robust risk factor for adverse cognitive outcomes, including accelerated cognitive decline and increased dementia risk. However, accumulating evidence suggests that the cognitive consequences of loneliness may be sex-specific, with women experiencing disproportionate exposure, vulnerability, and downstream effects across the life course. This mini-review synthesizes epidemiological, psychosocial, and neurobiological evidence linking loneliness to cognitive aging in women, highlighting sex differences in prevalence, social role exposures (e.g., caregiving, widowhood), stress responsivity, and neuroendocrine and inflammatory pathways. Findings from longitudinal cohort studies are reviewed, demonstrating stronger associations between loneliness and cognitive decline in women, alongside emerging mechanistic research implicating hypothalamic–pituitary–adrenal (HPA) axis dysregulation, immune activation, and hippocampal vulnerability. Critical gaps in aging neuroscience, including limited sex-disaggregated analyses and undermeasurement of relational and social variables, require urgent attention. A sex-sensitive framework for integrating loneliness into cognitive aging research and prevention strategies, emphasizing targeted assessment and intervention approaches that reflect women's lived social contexts, holds promise for advancing precision prevention in women's brain health. Framing loneliness as a modifiable, sex-specific risk factor offers a novel avenue for precision prevention in women's cognitive aging.

Keywords: Alzheimer's disease and related dementias, cognitive aging, Loneliness, Neuroinflammation, sex differences

Received: 09 Jan 2026; Accepted: 04 Feb 2026.

Copyright: © 2026 Warren. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Alison Warren

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