Is There a Link Between Alzheimer's Disease, Menopause & Hormone Therapy? - Ellen Dolgen
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Is There a Link Between Alzheimer’s Disease, Menopause & Hormone Therapy?

Did you know that women comprise two-thirds of the population with Alzheimer’s Disease (AD)?

According to the Alzheimer’s Association, “Emerging evidence suggests that Alzheimer’s-related brain changes may result from a complex interaction among abnormal tau and beta-amyloid proteins and several other factors. Tau is a protein that helps stabilize the internal skeleton of nerve cells (neurons) in the brain. This internal skeleton has a tube-like shape through which nutrients and other essential substances travel to reach different parts of the neuron. In Alzheimer’s disease, an abnormal form of tau builds up and causes the internal skeleton to fall apart.”

Mass General Brigham researchers found a relationship between the age of menopause and the use of hormone therapy (HT) and Alzheimer’s Disease (AD).

The results are published in JAMA Neurology. They show that going into menopause early may be a risk factor for AD dementia. It is important to note that early-age menopause is menopause that occurs spontaneously before age 40 or due to surgical intervention before age 45. However, the study showed that when women experiencing early-age menopause were prescribed hormone therapy (HT) at the onset of their menopause, they did not show an increased risk of AD. Estrogen may play a significant role in protecting the brain from AD, so it makes sense that this protective effect may be lost when our estrogen levels decrease.

According to corresponding author Rachel Buckley, Ph.D., of the Department of Neurology at Massachusetts General Hospital (MGH), “HT is the most reliable way to ameliorate severe menopause symptoms, but over the last few decades, there has been a lack of clarity on how HT affects the brain. We found that the highest levels of tau, a protein involved in Alzheimer’s disease, were only observed in hormone therapy users who reported a long delay between age at menopause onset and their initiation of hormone therapy. The idea that tau deposition may underlie the association between late hormone therapy intervention and Alzheimer’s disease dementia was a huge finding, something that hadn’t been seen before.”

Co-author JoAnn Manson, MD, MPH, DrPH, one of the lead investigators of the WHI and chief of the Division of Preventive Medicine at Brigham and Women’s Hospital, stated, “When it comes to hormone therapy, timing is everything. Our previous findings from the WHI suggested that starting HT early in menopause, rather than late initiation, provides better outcomes for heart disease, cognitive function, and all-cause mortality — and this study suggests that the same is true for tau deposition.”

The measurement of tau was the main focus of the study. Tau is present in more significant quantities in women compared to men in these brain regions.

According to Science Daily, “HT improves many severe symptoms related to menopause and has been hypothesized to also prevent cognitive impairment. However, two decades ago, the seminal Women’s Health Initiative (WHI) study found that HT use was associated with a nearly two-fold higher incidence of dementia compared to a placebo among women aged 65 years and older, possibly due to the initiation of HT many years after menopause onset.”

Researchers are planning on continuing to study the sex-specific risk factors for AD and tau’s role in women. They plan to research how tau impacts the brain and why early menopause and initiating HT late may increase tau. 

Frankly, I have never heard of tau before reading about this study. However, I am thrilled that researchers are studying how tau affects women. If you or someone you love goes into early menopause, do not wait – get thee to a menopause specialist!!! I have lots of tips on how to find one. It might be helpful to print this Menopause Mondays®Blog and bring it in with you to your menopause specialist so that you can have a detailed conversation about whether or not you are a candidate for hormone therapy.

My motto:  Suffering in silence is OUT!  Reaching out is IN.

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* does not recommend, endorse, or make any representation about any tests, studies, practices, procedures, treatments, services, opinions, healthcare providers, physicians, or medical institutions that may be mentioned or referenced.




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